SADDLE BLOCK WITH PETHIDINE FOR PERINEAL OPERATIONS

Small doses of morphine given intrathecally and extradurally produce long-lasting relief of chronic and postoperative pain in man (Behar et al., 1979; Wang, Nauss and Thomas, 1979). In addition to morphine, the efficacy of pethidine (Cousins et al., 1979), fentanyl (Bailey and Smith, 1980), metha-done and hydromorphone (Bromage, Camporesi and Chestnut, 1980) has been studied. Using the extradural route, all the opiates, including pethi-dine, were able to interrupt pain at a spinal level without affecting motor and autonomic control (Cousins et al., 1979). Recent studies (Mircea et al., 1982; Sandu et al., 1983) showed that pethidine, unlike mor-phine, when given intrathecally did not produce a selective segmental analgesia, but exhibited all the effects of the subarachnoid administration of local anaesthetics—including motor, sensory and sym-pathetic blockades. Thus spinal anaesthesia was obtained which was adequate for surgical inter-ventions, particularly in the perineal area. The purpose of this study was to assess the effectiveness of the intrathecal administration of pethidine in obtaining blockade, suitable for surgery on the perineum. PATIENTS AND METHODS Studies were carried out on 111 patients under-going perineal surgery between March 1983 and December 1984 (table I). The group included 77 men and 34 women, aged between 20 and 72 yr (mean age of 37 yr). Institutional approval and informed patient consent were obtained