Evaluating the Effect of Adjuant Intrathechal Meperidine along with Bupivacaine on Reducing Intraoperative Pain in Appendectomy Surgery

Spinal Anesthesia (SA) is a common safe technique for lower abdomen and extremities’ procedures. It shortens the hospitalization and recovery time, less nausea and vomiting and less Pulmonary complications during the surgery. Though SA has many advantages compared with General Anesthesia (GA), But common intrathecal medications, can’t suppress the visceral pain in abdominal procedures. Meperidine has a unique property of suppressing visceral pain, but its effect on intrathecal injection is controversial. In this study, we aim to assess the effect of intrathecal meperidine as an adjuvant to Bupivacaine to evaluate the pain score for appendectomy patients. In this double-blind study, 72 patients from 18 to 60 years old in ASA class 1,2 with acute appendicitis were divided into 2 groups using SA. Group A were injected 15mg Bupivacaine and 0.5 cc N.S (N=35) and Group B were injected 15 mg Bupivacaine along with 25μg (0.5 cc) Meperidine intrathecally (n=37). Pain score was recorded using VAS Score system during the surgery and Ketamine was the choice of analgesic if the patient had pain during the surgery. The mean VAS score in the group A was 3.69 ± 3.37, while in the group B it was significantly lower 1.14 ± 2.24 (P<0.01). Also, in Group B, lesser number of patients required analgesia with lesser dosage of analgesic (p=0.048). In this study, Bupivacaine and Meperidine intrathecally showed significant reduction in VAS pain score for the appendectomy surgery and reduced both number of the patients needing analgesia along with dosage required for pain relief.