The purpose of this study was to investigate the effect of adding meperidine to intrathecal heavy lidocaine on hemodynamic changes and blood loss in patients undergoing elective suprapubic open prostatectomy. Methods: In a randomized

double-blind clinical trial, 77 patients candidate for elective suprapubic open prostatectomy were allocated to two equal groups. All patients in the Inhibitors,research,lifescience,medical control and experimental groups received heavy lidocaine intrathecally. A low dose of meperidine was added to lidocaine in the experiment group. Changes in blood pressure and heart rate were measured and documented in several intervals. Blood loss, transfusion rate, shivering, nausea, vomiting, need to an Inhibitors,research,lifescience,medical analgesic drug, and transient neurologic symptoms were also recorded. Results: No significant difference was observed between the two groups in regards to blood pressure changes in operating room. Blood pressure increase was more prevalent among patients of the control group immediately in post-operating period. There were significantly (P<0.0001) less post-operative bleeding and need to transfusion in the experimental group. Inhibitors,research,lifescience,medical Conclusion: Adding low dose of meperidine

to lidocaine induces minimal effect on blood pressure change in operating room, but prevent increasing of blood pressure in post-operative period with a reduction of bleeding. Trial Registration Number: IRCT138903061936N2 Key Words: Blood loss, intrathecal, lidocaine, meperidine Introduction

Although the practice Inhibitors,research,lifescience,medical of anesthesia has had a very fast pace in recent years and a number of drugs and techniques are available in this regard, maintaining hemodynamic stability and preservation of blood volume during surgery still remain a Sotrastaurin concentration concern, especially in high risk patients.1,2 Patients who are candidates for open prostatic surgery are elderly with co-morbid cardiovascular and respiratory diseases and high risk for intraoperative bleeding.- Hemodynamic instability and major blood loss may predispose these Inhibitors,research,lifescience,medical patients to cardiac incidents during peri-operative period.5 Spinal anesthesia is a popular technique for managing patients in heptaminol need of open prostatic surgery. Lidocaine is the most popular local anesthetic drug utilized in diminutive surgical procedures, which may have adverse effects after the injection.- Opioids bind to well established receptors in the central nervous system (CNS) capable of producing long-time post-operative pain relief.9 However, there are several investigations on the effects of intratechal opioids added to local anesthetics on hemodynamic stability, but there are still a lot of controversies and no definite answer.10,11 The aim of this study was to examine the effect of adding meperdine to heavy intratechal lidocaine on blood pressure (BP) changes and blood loss. Comparisons were made to standard heavy intrathechal lidocaine.