Comparison of Spinal Anesthesia Quality Between Patients Addicted and Not Addicted to Opium

PURPOSE

This study aimed to compare the quality of spinal anesthesia between opium-dependent and opium-naive patients.

DESIGN

A case-control study.

METHODS

Two groups of subjects including opium-dependent and opium-naive patients (30 per group) were enrolled. Spinal anesthesia was performed using 15 mg of bupivacaine. The level of anesthesia was assessed every minute for 10 min and then every 10 min for 180 min. Motor block was recorded at 10, 60, 120, and 180 minutes. The duration of anesthesia was recorded.

FINDINGS

The mean duration of spinal anesthesia was significantly shorter in opium-dependent patients (101.45 ± 28.670) than in opium-naive patients (126.14 ± 24.206) (P = .003). The mean onset of sensory block was not significantly different between the two groups (4.14 ± 1.62 vs 3.69 ± 1.36, P = .259).

CONCLUSIONS

Substance abuse affects the duration of spinal anesthesia, so it is recommended to use intravenous medications or higher doses of spinal marcaine for these patients.

Performance of Local Anesthesia with Lidocaine among Opium Addicts and Non-Addicts; a Case Control Study

INTRODUCTION

Compared to ordinary people, addicts usually have a lower pain threshold. The current work attempts to compare the performance of local analgesia with lidocaine among opium addicts and non-addicts.

METHODS

In this case-control study, opium addicts and healthy patients with skin laceration referring to emergency departments of two educational hospitals were compared regarding the response to local anesthesia with lidocaine, as well as side effects.

RESULTS

197 cases with the mean age of 43.44 ± 20.12 years were studied (72.1% male). 98 (49.8%) cases were addicts and 99 (50.2%) were healthy people. Two groups were similar regarding age (p = 0.281), sex (p = 0.666), and wound size (p = 0.272). The amount of pain reduction 5 (df =1.5, F=0.38, p = 0.88) and 10 (df =1.5, F=0.58, p = 0.72) minutes after lidocaine injection was not different between the groups. Subgroup analysis based on sex and age of patient did not show any differences between the groups (p > 0.1 for all analysis). The mean duration of analgesia was 16.4 ± 5.37 minutes in addicts and 16.95±1.79 in control group (p = 0.334).

CONCLUSION

Lidocaine, as a commonly used local anesthetic agents, does not show different effects in addicts and non-addicts in repairing skin laceration.