Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Meperidine”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1978

Cord and maternal serum meperidine concentrations and clinical status of the infant.

The possible relationship between the use of meperidine during labor and fetal or neonatal distress was investigated by correlating clinical parameters with maternal and cord serum concentrations of meperidine. The serum concentration of meperidine was determined by a radioimmunoassay which is 100-fold more sensitive than previously employed techniques and can detect as little as 0.02 nmol meperidine/ml. The incidence of fetal or neonatal depression following meperidine administration was higher (6 of 17 infants) than in a control group but no correlation between suppression and the route of meperidine administration or the serum meperidine concentrations at the time of delivery was found.

Adolescent↗
PubMedDate not supplied

Meperidine serum concentrations and analgesic response in postsurgical patients.

We examined the relationship between serum concentrations of meperidine hydrochloride and analgesic response in postsurgical patients allowed to use patient-controlled analgesia (PCA) and compared these findings with those of patients receiving conventional intramuscular (IM) dosing. Six patients who had undergone abdominal surgery were randomly assigned to receive postoperative analgesia with either PCA or IM therapy. A sequence of five-point pain and sedation scores and serum meperidine concentrations were obtained in all patients the day after surgery. Minimum effective concentration (MEC) was defined as that concentration of meperidine at which patients felt pain relief as indicated by a decrease in pain rankings. The mean MEC for patients using PCA, 296 +/- 112 ng/mL, was significantly lower than the mean MEC in patients receiving IM dosing (551 +/- 164 ng/mL, p less than 0.05). The mean maximum change in meperidine concentrations in the PCA group, 177 +/- 88 ng/mL, was significantly lower than that of the IM group (484 +/- 125 ng/mL, p less than 0.05). Mean maximum changes in pain and sedation scores for patients in the PCA group were not significantly different from those of the IM group. During this investigation patients using PCA experienced smaller swings in meperidine concentrations than did patients receiving IM injections. MEC analysis suggests that PCA patients may experience pain relief at lower meperidine concentrations than those needed by IM patients.

Abdomen↗
PubMed1997

Continuous intrathecal meperidine via an implantable infusion pump for chronic, nonmalignant pain.

OBJECTIVE: To report a continuous infusion of intrathecal meperidine via an implanted infusion pump for nonmalignant, chronic pain. CASE SUMMARY: A 69-year-old white woman had chronic, nonmalignant low-back pain and bilateral leg pain. Multiple drug therapies and other interventional techniques had failed. The patient achieved significant pain relief by a continuous infusion of intrathecal meperidine via an implanted infusion pump. DISCUSSION: To our knowledge, this is the first report of meperidine administered intrathecally by continuous infusion. Continuous infusion of intrathecal and epidural opiates by implanted infusion pumps is becoming more widely recognized as an alternative treatment for patients with chronic, benign pain. Epidural and intrathecal meperidine is an effective analgesic for short-term surgical procedures. Data reporting effective relief and safety with continuous intrathecal meperidine remain limited. CONCLUSIONS: Continuous intrathecal meperidine via an implantable infusion pump may be an effective alternative in the treatment of chronic pain.

Aged↗
PubMed1990

Inotropic effect of meperidine: influence of receptor and ion channel blockers in the rat atrium.

Meperidine increases developed force in isolated rat atria. We initiated this study to determine if this positive inotropic effect was attenuated by commonly used receptor- and ion channel blockers. Neither naloxone (opioid blocker), phentolamine (alpha-adrenoceptor blocker), propranolol (beta-adrenoceptor blocker), polaramine (H1-receptor blocker), ranitidine (H2-receptor blocker), verapamil (calcium-channel blocker), nor lidocaine (fast sodium-channel blocker) attenuated the positive inotropic effect of meperidine. However, after lidocaine pretreatment meperidine increased contractile force by 57% (27%-80%) (median and 95% confidence interval), which is significantly more (P less than 0.001) than the 21% (13%-35%) increase seen after pretreatment with saline. After Na,K-pump inhibition by ouabain, meperidine caused no further increase in contractility, but the atria still responded to isoproterenol with an increase in developed force. Conversely, meperidine prevented the positive inotropic effect of ouabain. These findings suggest that the positive inotropic effect of meperidine is mediated by an increase in intracellular sodium activity and not by regulation of the slow inward calcium channel.

Animals↗
PubMed1993

Intranasal meperidine titration for postoperative pain relief.

A prospective, randomized, double-blind study investigating the efficacy of intranasal meperidine as compared with intravenous (i.v.) administration for postoperative pain relief is described. The study was limited to the initial titration of pain relief during a 2-h period immediately after surgery. Sixty women having undergone a hysterectomy were studied. Initially and when complaining of a pain intensity > or = 40 on the 101-point numerical rating scale (NRS), 30 patients received 6 sprays (27 mg) meperidine intranasally and simultaneously 6 mL NaCl 0.9% i.v. (nasal group); another 30 patients received 6 sprays of NaCl 0.9% intranasally and 6 mL of a diluted meperidine solution (27 mg) i.v. (intravenous group). Patients already having a pain reduction < 40 on the 101-point NRS, received half of the above dose. Meperidine was repeated every 5 min until the patients were pain free or refused further analgesic. Before the onset of meperidine titration and at 5- to 10-min intervals for 2 h thereafter, pain was evaluated with a 101-point NRS and a verbal rating scale. Within 20 and 35 min the pain scores evaluated by the NRS and verbal rating scale decreased in the intravenous and nasal group to a median of zero. The total dose of meperidine was 76.5 mg (range, 40.5-135.0) in the intravenous group and 104.4 mg (range, 27-135.0) in the nasal group (P < 0.05). One patient in each group showed a brief decrease in arterial hemoglobin oxygen saturation to < 90%. No patient complained of pain or burning in the nose.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗
PubMed2004

Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia.

UNLABELLED: Shivering associated with spinal anesthesia is uncomfortable and may interfere with monitoring. We performed this prospective, double-blinded, and randomized study to determine whether intrathecal meperidine (0.2 mg/kg) decreases the incidence and intensity of shivering after spinal anesthesia for cesarean delivery. Forty parturients scheduled for nonemergent cesarean delivery were enrolled in two groups. Spinal anesthesia consisted of hyperbaric bupivacaine (0.75%; 10.5 mg), morphine 0.15 mg, and, in the experimental group, meperidine (0.2 mg/kg) or, in the control group, normal saline. Data collection, including sensory block level, blood pressure, core temperature, and shivering intensity, was performed every minute for 10 min, every 3 min for 33 min, and then every 5 min until the sensory level receded to L4. Time to highest sensory level, maximum number of blocked segments, sensory and motor blockade regression, and systolic blood pressure showed no difference between groups. The incidence of shivering was less (P < 0.02) in the meperidine group, as was its intensity (P < 0.003). Intrathecal meperidine (0.2 mg/kg) is effective in reducing the incidence and intensity of shivering associated with spinal anesthesia for cesarean delivery. IMPLICATIONS: Previous studies have suggested that IV meperidine is helpful for treating intraoperative shivering. This study was undertaken to evaluate spinal meperidine and found that it decreases the incidence and intensity of shivering associated with spinal anesthesia for cesarean delivery.

Adult↗
PubMed1988

Human fetal oxygenation (tcPo2), heart rate variability and uterine activity following maternal administration of meperidine.

Fetal tcPo2 levels were measured in 10 patients following maternal administration of 50 mg of meperidine by intravenous route. About 3 minutes following injection of meperidine, tcPo2 values started to decline to reach the lowest value of 37 +/- 25% by 7 mins of injection. tcPo2 values recovered by about 15 mins following injection. These changes in fetal tcPo2 levels preceded transient minimal increase in FHR variability. The increase in FHR variability was followed immediately by a decrease in the indices of the FHR variability. The uterine activity began to decline below the predicted positive slope values shortly following injection of meperidine. This decline was maximum 15 mins post-injection, subsequently establishing a trajectory toward the positive values expected for unmedicated labor. Two patients receiving 25 mg intravenous meperidine demonstrated no decline in tcPo2 levels; however, in the patient receiving 75 mg of intravenous meperidine, the changes noted were similar to those observed following 50 mg of meperidine.

Adolescent↗
PubMed2000

The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine.

STUDY OBJECTIVE: To determine the effects of ritonavir on the pharmacokinetics of meperidine and normeperidine. DESIGN: Open-label, crossover, pharmacokinetic study. SETTING: United States government research hospital. SUBJECTS: Eight healthy volunteers who tested negative for the human immunodeficiency virus. INTERVENTION: Subjects received oral meperidine 50 mg and had serial blood samples collected for 48 hours. They then received ritonavir 500 mg twice/day for 10 days, followed by administration of a second 50-mg meperidine dose and collection of serial samples. MEASUREMENTS AND MAIN RESULTS: Plasma samples were assayed for meperidine, normeperidine, and ritonavir. Meperidine's area under the curve (AUC) decreased in all subjects by a mean of 67+/-4% in the presence of ritonavir (p<0.005). Mean +/- SD maximum concentration was decreased from 126+/-47 to 51+/-21 ng/ml. Normeperidine's mean AUC was increased 47%, suggesting induction of hepatic metabolism. CONCLUSION: Meperidine's AUC is significantly reduced, not increased, by concomitant ritonavir. Based on these findings, the risk of narcotic-related adverse effects from this combination appears to be minimal. However, increased concentrations of normeperidine suggest a potential for toxicity with increased dosages or long-term therapy.

Adult↗
PubMed1999

Binding and hydrolysis of meperidine by human liver carboxylesterase hCE-1.

Human liver carboxylesterases catalyze the hydrolysis of apolar drug or xenobiotic esters into more soluble acid and alcohol products for elimination. Two carboxylesterases, hCE-1 and hCE-2, have been purified and characterized with respect to their role in cocaine and heroin hydrolysis. The binding of meperidine (Demerol) and propoxyphene (Darvon) was examined in a competitive binding, spectrophotometric assay. The hCE-1 and hCE-2 bound both drugs, with Ki values in the 0.4- to 1.3-mM range. Meperidine was hydrolyzed to meperidinic acid and ethanol by hCE-1 but not hCE-2. The Km of hCE-1 for meperidine was 1.9 mM and the kcat (catalytic rate constant) was 0.67 min-1. Hydrolysis of meperidine by hCE-1 was consistent with its specificity for hydrolysis of esters containing simple aliphatic alcohol substituents. Hence, hCE-1 in human liver microsomes may play an important role in meperidine elimination. Propoxyphene was not hydrolyzed by hCE-1 or hCE-2. This observation is consistent with the absence of a major hydrolytic pathway for propoxyphene metabolism in humans.

Analgesics, Opioid↗
PubMedDate not supplied

Oral midazolam with and without meperidine for management of the difficult young pediatric dental patient: a retrospective study.

PURPOSE: The purpose of this retrospective study was to examine different dosages of midazolam used alone or in combination with different dosages of meperidine for managing difficult young pediatric dental patients. METHODS: Patient records and sedation logs of 120 moderately to severely apprehensive/ uncooperative subjects, ages 24-48 mos, sedated in private practice setting, were reviewed. Subjects, divided into six groups of 20, received midazolam in doses of 0.7 or 1.0 mg/kg with and without meperidine in doses of 1.0 or 1.5 mg/kg. Ratings of the effectiveness of sedation, duration of action, need for restraint to accomplish treatment, and recovery times were made. Nitrous oxide was not used. RESULTS: When used alone, use of 0.7 mg/kg midazolam produced the most agitation, required restraint most frequently, and produced the shortest working time (P<0.001). Subjects receiving 1.0 mg/kg midazolam and meperidine were the most effective, completing 20/20 visits with no need for restraint, no loss of consciousness throughout appointments, and no adverse reactions (P<0.001). Use of lower dose midazolam and higher dose meperidine was reliable, permitting treatment to be completed without restraint in 18/20 patients. Combined higher doses of both agents demonstrated somnolence and oversedation. The addition of meperidine increased working time (P<0.05). CONCLUSIONS: The addition of meperidine appears to enhance the effectiveness and duration of action of midazolam for managing difficult young pediatric patients.

Adjuvants, Anesthesia↗
PubMed2002

Effectiveness of intravenous meperidine for pain relief in the first stage of labour.

OBJECTIVE: To determine the effectiveness and side effects of intravenous meperidine in labour pain relief. MATERIAL AND METHOD: A double blind, randomized controlled trial was conducted in 84 parturients, using normal saline as control. Visual analogue scale, postpartum parturients' opinion of effectiveness, sedative scores, nausea/vomiting, dizziness, delivery method, Apgar scores, and naloxone prescription were assessed. RESULT: There were no statistically significant differences between the mean and median of visual analogue scale of meperidine and control group. In addition, the sedative scores, nausea/vomiting and dizziness in the meperidine group occurred more than those in the control group significantly. Even mean of the pain increment in the meperidine group was less than those in the control group (p < 0.05). The parturients' opinion on the effectiveness of pain relief during labor within 24 hours of the first postpartum day was only 23.80 per cent in the meperidine group, however, it was statistically significantly different when compared to 7.10 per cent in the control group. CONCLUSION: Intravenous meperidine exhibited the effectiveness of pain relief of only 23.80 per cent of the subjects, in addition, it may cause many side effects.

Adult↗
PubMed2003

[Negative inotropic effect of meperidine in rat ventricular muscle and the underlying mechanism].

The purpose of the present study was to investigate the effect of meperidine on rat ventricular muscle. Cardiac function was assessed in Langendorff-perfused rat hearts and intracellular calcium level was recorded in enzymatically isolated rat ventricular myocytes using spectrofluorometric techniques. To explore the underlying mechanism, whole-cell configuration of patch-clamp technique was used to record L-type Ca(2+) current. The results showed that meperidine decreased the product of heart rate and left ventricular developed pressure (LVDP HR), maximal rate of the left ventricular pressure increase (LV +dP/dt(max)) and decrease (LV -dP/dt(max)), but increased left ventricular end-diastolic pressure in a dose-dependent manner (0-1000 micromol/L). Meperidine also produced a dose-dependent reduction in electrically induced [Ca(2+)](i) transient amplitude and an increase in diastolic [Ca(2+)](i) baseline level, but did not alter the caffeine (20 mmol/L) induced Ca(2+) release from intracellular ryanodine-sensitive Ca(2+) stores. Meperidine at 100 micromol/L inhibited L-type Ca(2+) current to 67.4 10.1% of control but did not affect the voltage dependency of activation and inactivation. The inhibitory effect of meperidine on Ca(2+) current could not be prevented by pretreatment with the opioid receptor antagonist naloxone. These data suggest that meperidine exerts a negative inotropic effect by inhibiting L-type Ca(2+) current. The lack of effect of naloxone implies that the action is independent of the opioid receptor.

Animals↗
PubMed1992

[Intramuscular meperidine for the prevention of shivering in spinal anesthesia].

Intravenous meperidine 25mg has been employed effectively to treat shivering following regional anesthesia and general anesthesia. The study was designed to evaluate the effectiveness of intramuscular meperidine for the prevention of shivering in spinal anesthesia. The series consisted of 60 patients who were divided into 2 groups with 30 patients in each, undergoing lower abdominal or lower extremity surgery. All patients were given diazepam 0.1mg/kg i.v. for anxiolysis when they came to the operating room. In a double blind and randomized fashion, patients in the study (meperidine) group received meperidine 25mg IM (= 0.5ml). In the control group 0.9% N/S 0.5ml IM was given instead. All patients received spinal anesthesia 15 minutes later. Measurement of the levels of sensory loss to pinprick was made. The ambient temperature and the rectal temperature were continuously monitored to evaluate the effect of the change in body temperature on shivering during operation. The degree and the occurrence of shivering were carefully evaluated and recorded by a blind-trust observer. There was no significant difference in maximal analgesic level, ambient temperature and change of rectal temperature during operation between the groups. Shivering occurred in 17 patients (56.7%) in the saline group with an onset time of 7.9 +/- 2.5min following spinal anesthesia. In the meperidine group, shivering occurred only in 3 patients (10%) with an onset time of 54 +/- 29.5min after spinal anesthesia. There was a significantly lower incidence of shivering in the meperidine group than in the saline group (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMedDate not supplied

Ion-trapping of meperidine: influence of antacid treatments on serum and gastric fluid concentrations.

The ascorbic acid pretreated beagle dog was used to demonstrate the phenomenon of ion-trapping and the influence of three different antacid treatments on the serum and gastric fluid concentration of meperidine: pretreatment with magnesium-aluminum hydroxide (MA), pretreatment with cimetidine (C), and periodic total aspiration of gastric fluid (ASP). A significant correlation between pH and the meperidine concentration in gastric fluid was found; the lower the pH the higher is the secretion of meperidine into gastric fluid. The gastric fluid meperidine concentrations were 8-30 times as high as the respective serum concentrations. No significant differences between the meperidine concentration in the gastric fluid were found among the three treatments, MA, C, or ASP, versus control. Meperidine serum concentrations differed significantly versus control on two times for MA and on one time for ASP. The elimination half-life [h] and the mean residence time [h] differed significantly in the MA treatment (1.15 +/- 0.02 h and 1.23 +/- 0.24 h) versus control (1.90 +/- 0.19 h and 2.00 +/- 0.15 h).(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum Hydroxide↗
PubMed1990

Potential for nonnarcotic analgesics to save personnel costs associated with controlling injectable morphine and meperidine.

The personnel costs associated with handling injectable morphine and meperidine in five hospitals were determined, and the potential savings from using a non-controlled analgesic as an alternative were estimated. Five distinctly different U.S. hospitals were selected for study. Tasks involved in the acquisition, distribution, and preparation of injectable doses of morphine and meperidine were identified, and data on the personnel time required to complete each task were collected. Personnel costs were calculated on the basis of per minute wage rates, and costs that could be avoided if injectable morphine and meperidine were replaced by a nonnarcotic analgesic were estimated by determining the relevance of each task to the use of a noncontrolled injectable agent. The total personnel cost of controlling morphine and meperidine ranged from $0.55 to $0.93 per dose; the weighted average cost was $0.64 per dose. The savings that could be realized by replacing injectable morphine and meperidine with a noncontrolled injectable analgesic ranged from $0.13 to $0.36 per dose; the weighted average avoidable cost was $0.23 per dose. Eliminating the need to control these medications might not result in savings in dollar terms but would free health-care workers to perform other tasks. If costs are interpreted in terms of lost opportunities, such savings are real. The use of a nonnarcotic injectable analgesic in place of injectable morphine and meperidine could save approximately $0.23 in personnel costs per dose at the study hospitals.

Analgesics↗
PubMed1988

Feasibility study for transdermal delivery of meperidine.

The present study examines the feasibility of meperidine for transdermal delivery. Meperidine possesses characteristics favorable for percutaneous absorption, i.e., a high lipid/water partition coefficient of 25 at pH 7.4, a low molecular weight of 247, and water solubility. Following solubility and apparent partition coefficient experiments, meperidine base rather than salt, was chosen for permeation experiments. The release of meperidine from a drug delivery device (disc) was studied in vitro. Ex vivo permeation of meperidine through excised rat skin was studied using the Thomas diffusion cell, and the fluxes from different solvents were compared. From the in vitro and ex vivo studies, a disc was chosen for final in vivo evaluation in rats, and compared to I.V. and P.O. administration of meperidine.

Administration, Cutaneous↗
PubMed1977

Radioimmunoassay for normeperidine: studies on the N-dealkylation of meperidine and anileridine.

A sensitive and specific radioimmunoassay for normeperidine has been developed that can detect as little as 100 pg of this metabolite. In competitive binding experiments with [125I]O-tyramyl-normeperidinic acid and an antiserum produced in rabbits immunized with a bovine serum albumin-normeperidinic acid conjugate, meperidine is only 0.01% as effective an inhibitor as normeperidine. Therefore, normeperidine can be determined in physiological fluids and in tissue extracts when relatively large amounts of meperidine or other N-phenylpiperidine esters are present. High pressure liquid chromatography can be used to confirm the results obtained by radioimmunoassay during the in vitro N-dealkylations of meperidine and anileridine to normeperidine. The normeperidine isolated by high pressure liquid chromatography accounts for all of the inhibitory reactivity determined in the enzymatic digests by the radioimmunoassay. Kinetic parameters (Km and Vmax) can be determined for the N-dealkylation of meperidine and anileridine. The formation of normeperidine with time can be followed in rabbits injected with meperidine or anileridine. Plasma levels may also be determined when meperidine is administered as an obsteric analgesic.

Animals↗
PubMedDate not supplied

Kinetics of meperidine N-demethylation in the perfused rat liver preparation.

Meperidine and normeperidine elimination was studied in the once-through perfused rat liver preparation. Biliary excretion of these bases was minimal, and nonlinear metabolism of meperidine (extraction ratio of 1.0 to 0.89 at 1 to 19 micrograms/ml) and normeperidine (extraction ratio of 0.6 to 0.1 at 1 to 25 micrograms/ml) was observed when input concentration was increased. The rate of efflux of normeperidine in hepatic venous blood represented an increasing proportion of the rate of presentation and the rate of loss of meperidine (34 to 92%) at increasing meperidine input concentration. But when the data were corrected for the nonlinear sequential metabolism of normeperidine, the rate of N-demethylation accounted completely for the rate of metabolism of meperidine. These N-demethylation rates obeyed Michaelis-Menten behavior, and appeared to be saturated at input meperidine concentration greater than 5 micrograms/ml.

Animals↗