Intrathecal pethidine as a sole anesthetic agent for lower limb surgery: a case report

Spinal anesthesia is the most preferred method for lower extremity surgery owing to rapid onset, predictable and reliable block, and excellent postoperative analgesia. Pethidine is the only opioid that can be used as a sole anesthetic agent in spinal anesthesia, because of its local anesthetic activity which is unique. As there are scant articles about pethidine as a sole anesthetic agent in spinal anesthesia, this encouraged us to report intrathecal pethidine used for two old patents for their femoral fractures repair. Spinal anesthesia was carried out using 1.6 mL pethidine (50 mg/mL) in the sitting position in the midline approach by a 24-gauge, Quincke point needle. The patients were successfully managed with this method. This report emphasizes that in some situations, intrathecal pethidine technique is a safe, and good alternative inexpensive technique over spinal anesthesia with local anesthetics.