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 253 records · Page 14Linked to original sources
PubMed2002

Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour.

BACKGROUND: Concern has been expressed that epidural analgesia for labour may be associated with a higher incidence of backache. METHODS: A prospective randomized trial investigating the effect of epidural analgesia on the outcome of labour in nulliparae, mothers were randomized to receive either epidural analgesia or meperidine. A questionnaire on postnatal symptoms was sent to them 6 months after delivery. RESULTS: In all, 611 mothers were studied; 310 were randomly allocated to receive i.m. meperidine up to 300 mg and 301 to receive epidural bupivacaine. The response rate to our questionnaire was 83%. Intention-to-treat analysis showed similar prevalence rates of postpartum backache in the epidural (48%) and meperidine groups (50%), with an observed difference (epidural-meperidine) of -2% (95% CI, -11 to +6%). After excluding mothers with backache before delivery, there were also similar incidence rates of postpartum backache in the epidural (29%) and meperidine groups (28%), observed difference 1% (95% CI, -8 to +10%). CONCLUSIONS: Epidural analgesia in labour was not associated with an increase in the prevalence or incidence of backache.

Analgesia, Epidural↗
PubMedDate not supplied

Dose-responsive characteristics of meperidine sedation in preschool children.

Using double-blind conditions, 60 uncooperative and fearful preschool children (24-66 months) received intramuscular injections of meperidine 0.25, 0.50, 1.00 mg/lb or placebo prior to restorative dental treatment. Behavior was assessed by the dentist and an independent observer during five specific treatment procedures. Behavioral ratings found meperidine to be an effective sedative, with 0.50 mg/lb and 1.00 mg/lb being significantly more effective than placebo (P less than 0.05, Kruskal-Wallis). Children receiving 1.0 mg/lb of meperidine had significantly more nausea and vomiting than patients receiving lower doses of the drug (P less than 0.05, Chisquare). Physiologic monitoring demonstrated that the highest dose of meperidine was associated with transient drops in arterial oxygen saturation. Meperidine sedation was found to be more effective for older children (37-66 months) and for children initially rated as being only moderately uncooperative and fearful.

Anxiety↗
PubMed1990

Efficacy and safety of single doses of intramuscular ketorolac tromethamine compared with meperidine for postoperative pain.

Ketorolac tromethamine, a potent nonnarcotic prostaglandin synthetase-inhibiting analgesic, was compared with meperidine for relief of moderate to severe postoperative pain. In a double-blind, randomized study, 125 patients received single intramuscular doses of ketorolac 30 or 90 mg or meperidine 50 or 100 mg. The degree of pain and pain relief were quantified verbally and with visual analog scales at baseline and 30 minutes, then hourly for 6 hours. Ketorolac 30 and 90 mg were significantly superior to meperidine 50 mg in six of nine efficacy measures. The onset of and peak analgesic effect of both doses of ketorolac and of meperidine were equivalent. Compared with both doses of meperidine, the two doses of ketorolac exhibited significantly longer duration of analgesic effect, as measured by the percentage of patients who terminated the study because of inadequate pain relief. The frequency of side effects was not significantly different between the drugs. The prolonged efficacy of intramuscular ketorolac combined with the reduced risk of respiratory depression suggest an important use of this drug for the relief of postoperative pain.

Adolescent↗
PubMed1989

Intravenous meperidine during labor: a randomized comparison between nursing- and patient-controlled administration.

Preliminary reports about patient-controlled analgesia during labor have been promising. The purpose of this investigation was to compare our experience with meperidine given intravenously by the patient versus by a nurse. Sixty-four healthy women beginning active labor (cervical dilation 3 cm) at term were randomly assigned to either self-administer a 10-mg dose as often as every 20 minutes or have a nurse administer 25-50 mg every 3 hours as requested. The total meperidine dose and consumption rates were greater when administered by the patient than by a nurse. Maternal side effects occurred with similar frequency in both groups, and pain relief was judged to be equivalent. Maternal and umbilical serum concentrations of meperidine at delivery increased in the patient-controlled group if active labor lasted longer than 2 hours. Neonatal naloxone therapy was used more often when meperidine was administered by the patient than by a nurse (five of 31, 16%, versus three of 33, 10%, respectively). Self-administration of intravenous meperidine by the laboring patient was not found to be advantageous over nursing administration, and may pose an increased threat to the infant.

Adult↗
PubMed1989

Randomized comparison of meperidine and fentanyl during labor.

This randomized investigation compared the efficacy of the conventional narcotic, meperidine, and a more potent and short-acting analgesic, fentanyl, during labor. One hundred five women with uncomplicated term pregnancies in active labor were randomly assigned to receive either intravenous fentanyl (50-100 micrograms every hour) or meperidine (25-50 mg every 2-3 hours) in a non-blinded manner. The analgesics were rated equivalent in efficacy. Maternal nausea, vomiting, and prolonged sedation occurred more frequently in the meperidine group. Naloxone use was significantly less in fentanyl- than in meperidine-exposed infants (one of 49 versus seven of 56; P less than .05). Neuroadaptive testing at approximately 2 hours and 24 hours postnatally revealed similar averaged scores in the two groups. Using the described intravenous dosing schedule, fentanyl was preferable to meperidine during labor because there was no prolonged maternal sedation or vomiting necessitating therapy and the requirement for neonatal naloxone was reduced.

Analgesia↗
PubMedDate not supplied

Comparison of chloral hydrate-hydroxyzine with and without meperidine for management of the difficult pediatric patient.

This study attempted to examine the impact of low doses of meperidine on the effectiveness of two doses of CH for management of highly resistive young pediatric dental patients. The results suggest patient manageability was enhanced by the addition of oral meperidine. As an alternative to a parenteral technique or general anesthetic, the clinician may wish to consider this regimen after having experienced failure of CH either alone, or in combination with an antiemetic, to produce an adequate level of sedation. The extent to which application of physical restraint is considered necessary or acceptable should be taken into account, when evaluating the need for a regimen of medication. If the purpose of selecting a sedative technique is to accomplish lengthy treatment without harsh restraint, the degree to which restraint is needed no doubt reflects on the adequacy of the sedative regimen. The addition of meperidine was found to reduce significantly the need for persistent harsh physical restraint, to allow treatment of the refractory young child. While the brief application of harsh restraint measures may be warranted and justifiable in emergency medical situations, it seems unwise to make use of harsh restraint for lengthy elective dental procedures. Given the extent to which many adults report negative childhood dental experiences, avoidance of the use of aversive measures seems desirable. Of the cases receiving meperidine, 76.3 percent were treated successfully (no need for persistent restraint), compared to the successful treatment of only 30.7 percent of the patients sedated without meperidine.(ABSTRACT TRUNCATED AT 250 WORDS)

Child Behavior↗
PubMed1987

Pain relief after major abdominal surgery: a double-blind controlled comparison of sublingual buprenorphine, intramuscular buprenorphine, and intramuscular meperidine.

In a double-blind randomized study of three groups of 18 patients scheduled for major abdominal surgery the efficacy and side effects of sublingual buprenorphine were tested and compared to intramuscular meperidine and buprenorphine. Single doses of either 75 mg of meperidine, 0.4 mg of sublingual buprenorphine, or 0.3 mg of intramuscular buprenorphine were used. Patients given buprenorphine as sublingual tablets were significantly more conscious in the immediate postoperative period (Glasgow Coma Scale) than when given buprenorphine or meperidine intramuscularly. Median pain intensity differences (PID) showed equal pain relief, whereas the summarized pain intensity differences (SPID) were significantly higher in the intramuscular buprenorphine group compared to the meperidine group. Three cases of respiratory acidosis in the meperidine group required IPPV treatment, and one case in the intramuscular buprenorphine group required treatment. Sedation and nausea were the most common side effects in all three groups. We conclude that sublingual buprenorphine is useful for relief of postoperative pain and exhibited administrative advantages, when the patients were able to cooperate.

Abdomen↗
PubMed1986

Meperidine disposition in burn patients.

Limited information is available describing the pharmacokinetics of hepatically-cleared drugs in burn patients. Based on the hypothesis that after burn injury, plasma meperidine clearance should increase in response to the postburn increase in hepatic blood flow, we examined the kinetics of intravenous meperidine in eleven patients about one week after burn injury (acute study) and in five of these patients about six weeks postburn (convalescent study). The meperidine steady-state distribution volume (about 2 1/kg) during both the acute and the convalescent studies was about half the distribution volume reported in the literature for meperidine in healthy subjects. The meperidine clearance in burn patients (acute, 420 ml/min and convalescent, 600 ml/min) was lower than would be anticipated in the presence of known marked increases in hepatic blood flow in burn patients.

Adolescent↗
PubMed1981

Dual action of meperidine on the frog neuromuscular junction: a prejunctional, opiate receptor-mediated depression of transmitter release and a postjunctional, nonopiate receptor effect on the endplate.

The action of meperidine was investigated on the frog sciatic nerve-sartorius muscle in vitro. Meperidine (5 X 10(-5) M to 2 X 10(-4) M) depressed the twitch response to nerve stimulation but potentiated the response to direct muscle stimulation. When the nerve terminal action potential and the endplate potential (EPP) were recorded simultaneously, the EPP was depressed by meperidine but only a small and variable decrease in the nerve terminal action potential was observed which did not produce the EPP depression. The depression of the EPP was partly antagonized by naloxone (3 X 10(-8) M). Meperidine also depressed the EPP produced by iontophoresis of acetylcholine onto the endplate, but this depression was not antagonized by naloxone. It is concluded that there are two meperidine actions on junctional transmission in this preparation. One, a depression of the prejunctional transmitter release process. This depression is partly, if not completely, opiate receptor-mediated. The second is a depression of the response of the endplate to acetylcholine. The latter effect does not involve a naloxone-sensitive opiate receptor.

Acetylcholine↗
PubMed1981

Pharmacokinetics of high-dose meperidine in surgical patients.

Intravenous meperidine is used during surgical procedures at doses up to 5 mg/kg. At the commonly used analgesic intravenous doses of 50 to 100 mg (0.7 to 1.4 mg/kg), the drug exhibits two-compartment open model pharmacokinetics with elimination primarily by hepatic metabolism (> 90% of a dose). Drugs eliminated to a large extent by metabolism may, however, be subject to dose-dependent kinetics. We therefore studied the pharmacokinetics of surgery involving the lower part of the abdominal aorta and the femoral and popliteal arteries. Serial blood samples were collected over 10 hours and plasma meperidine concentrations were determined by a gas chromatographic assay. Semilogarithmic plots of plasma meperidine concentration vs time were biphasic; however, the curves' irregularities during the time the arterial vessels were clamped suggest that the data should be analyzed in a model-independent manner. These irregularities suggest that the disposition of meperidine is altered during the clamping period and that these alterations are quickly reversed following removal of the clamp. Our findings agree with those reported in the literature following a total dose of 50 mg (half-life average 4.4 hours, total plasma clearance 10.4 ml/min/kg, and apparent volume of distribution 3.74 L/kg). The present results thus indicate that although meperidine is eliminated to a large extent by metabolism, the processes involved are apparently not saturated at doses 7 times greater than normal.

Aged↗
PubMedDate not supplied

Spinal anesthesia with meperidine as the sole agent for cesarean delivery.

BACKGROUND AND OBJECTIVES: Meperidine is an opioid with local anesthetic properties that produces spinal anesthesia after subarachnoid injection for surgical procedures. The aim of this study was to evaluate the clinical relevance of spinal meperidine for cesarean delivery. METHODS: Twenty-eight ASA I-III parturients scheduled for cesarean delivery were included in the study. Meperidine 1 mg/kg was administered subarachnoid. Patients were monitored for appropriate anesthesia and side effects. RESULTS: Cesarean delivery was successfully performed under spinal meperidine in 22 cases: two cases required general anesthesia before incision and the duration of sensory anesthesia was too short in four cases. Side effects included moderate hypotension (decrease in arterial blood pressure > 30 mm Hg in 36% of the cases), nausea (32%), and pruritus (10.7%). No respiratory depression was documented in mothers and newborns. CONCLUSIONS: Although short-acting, meperidine can be used as a substitute for local anesthetics for cesarean delivery, especially when local anesthetics are not available.

Adolescent↗
PubMed1993

[Intrathecal meperidine attenuates shivering induced by spinal anesthesia].

Shivering is a common and complex phenomenon that occurs in many patients during spinal anesthesia. Shivering can increase oxygen consumption up to 500 per cent which may be detrimental to patients with decreased myocardial reserve. The metabolic costs and cardiorespiratory consequences of shivering are important particularly for patients with anemia, coronary arterial disease, cardiopulmonary insufficient, debilitated status or are elderly. We studied whether intrathecal meperidine could prevent shivering after spinal anesthesia. 60 patients with ASA class I-II were divided into intrathecal meperidine group (Group I) (n = 30) and control group (Group II) (n = 30). Group I received spinal tetracaine 12-16 mg with meperidine 0.2 mg/kg and Group II received spinal tetracaine 12-16 mg without meperidine. During operation the highest level of spinal anesthesia, ambient and rectal temperatures, blood pressure (BP) and heart rate (HR), presence or absence of shivering, intensity of shivering in both groups were recorded. Close observation for side effects was given post-operatively. There was a significant reduction (p < .005) in incidence of shivering in group I patients (16.7%) when compared with group II (56.7%). There was no or less side effects observed with other neuraxial opioids except nausea. We concluded that intrathecal meperidine could suppress shivering induced by spinal anesthesia.

Adult↗
PubMedDate not supplied

[Patient-controlled analgesia using meperidine in the postoperative period after cholecystectomy. Study of possible complications at 2 different levels of surveillance].

OBJECTIVES: To ascertain the side effects of intravenous meperidine in patient-controlled analgesia under two levels of surveillance: one in the recovery room and one in the hospital's surgical ward. PATIENTS AND METHODS: Patient-controlled analgesia with meperidine was made available to 80 patients who had undergone cholecystectomy by laparotomy. Instances of nausea/vomiting, pruritus, urinary retention and technical problems were recorded, as well as arterial gas levels (cooximetry) on the first, third, twelfth and twenty-fourth hours after surgery. We also recorded meperidine consumption and its relationship to side affects. RESULTS: Side effects were associated with higher consumption of meperidine (437.0 +/- 117.7 mg vs 297.7 +/- 135.9 mg in those experiencing no side effects), with more episodes of PO2 < 70 mmHg and SO2 < 90% on the ward than in the recovery room (24 and 10 as compared to 85 and 30, respectively). Patients presenting adverse side effects were significantly older (76.6 +/- 13.5 vs 58.1 +/- 11.1 years). CONCLUSIONS: Given that age and higher meperidine consumption were associated with more frequent occurrence of hypoxic episodes, patients should receive greater surveillance on the ward, with oxygen therapy, monitoring of accumulated consumption and caution used with older patients.

Age Factors↗
PubMedDate not supplied

Central nervous system toxicity associated with meperidine use in hepatic disease.

Meperidine-associated central nervous system (CNS) excitatory toxicities are believed to be caused by accumulation of the active metabolite normeperidine. Normeperidine is eliminated by the kidneys and accumulates in patients with renal insufficiency, sickle cell disease, and cancer. In patients with cirrhosis, the metabolism of meperidine is decreased, leading to accumulation of the parent drug and possible CNS depressive effects similar to hepatic encephalopathy. Although the elimination of normeperidine is decreased as well in these patients, the ratio of normeperidine to meperidine is generally low, and the narcotic effects of meperidine usually predominate. This is the first reported case of CNS excitatory toxicities in a patient with alcoholic hepatitis and cirrhosis, and normal renal function. Administration of multiple doses of meperidine in patients with hepatic disease should be discouraged.

Adult↗
PubMedDate not supplied

Meperidine attenuates the febrile response to endotoxin and interleukin-1 alpha in rats.

Intravenous meperidine is commonly used to treat rigors and chills in febrile patients, though its mechanism of action is unknown. Therefore a laboratory model of pyrogen-induced fever was used to evaluate the effects of meperidine on the febrile response of rats injected with bacterial endotoxin or IL-1 alpha. Fever was measured using a computerized biotelemetry system for the continuous monitoring of body temperature. Injection of meperidine blocked the onset of fever in rats injected with endotoxin and attenuated the febrile response in rats injected with IL-1 beta. Furthermore, incubation of human mononuclear leukocytes (MNL) in the presence of meperidine significantly reduced endotoxin-induced secretion of IL-1 beta in vitro. These data suggest that meperidine decreases rigors and chills by decreasing the "set point" for fever, perhaps by reducing MNL secretion of IL-1 beta.

Animals↗
PubMed1993

[Midazolam and Meperidine for colonoscopy].

We studied the sedative, analgesic and amnesic effects of intravenous midazolam and meperidine for colonoscopy, and also compared patient's satisfaction, changes of vital signs, safety and complications with intramuscular meperidine during the colonoscopy. Two hundred and ninety-nine patients undergoing physical check-up were randomized to receive intramuscular meperidine 50 mg and Hyoscine-N-Butylbromide (buscopan) 20 mg (Group IM-MB, n = 57) or intravenous midazolam 0.05 mg/kg, meperidine 1 mg/kg and buscopan 20 mg (Group IV-MMB, n = 242) before colonoscopy. All patients were closely observed and arterial oxygen saturations (SaO2) were monitored with pulse oximeter in Group IV-MMB. The demographic data of both groups were similar. There were significantly more severe pain responses (grimacing, moaning, shouting for pain, abdominal rigidity and body moving during colonoscopy) in Group IM-MB (51%) than in Group IV-MMB (13%) (p < 0.01). In immediate procedure recall after recovery from medications, 39% of Group IM-MB remembered severe pain during colonoscopy and only 3% of Group IV-MMB did (p < 0.01). 92% of Group IV-MMB who felt satisfactory with the medications were significantly higher than 21% in Group IM-MB (p < 0.01). Both groups significantly increased in heart rate after the injection of medications (p < 0.01). Group IM-MB increased 15 +/- 18% and Group IV-MMB 61 +/- 28% with significant difference between groups (p < 0.01). This might be caused by meperidine, buscopan, and relative hypovolemia of patients. There were significant decreases in SaO2 in Group IV-MMB, mean 4.5 +/- 1.7% (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

The influence of meperidine and nitrous oxide on respiratory depression in rats.

Narcotic sedation is commonly accomplished with nitrous oxide (N2O) coadministration. Concerns regarding respiratory morbidity and mortality with drug combinations have been reported in the literature, particularly in patients not receiving supplemental oxygen (O2). The purpose of this investigation was to determine the effect of meperidine alone and in combination with N2O on respiration in laboratory rats by evaluating cardiovascular and arterial blood gas data. Fifty-four Sprague-Dawley rats were assigned to one of six groups (nine per group). Groups were allocated based upon the dosage of meperidine administered (0, 4.0, or 8.0 mg/kg intraperitoneally [i.p.]) and exposure to N2O (50% with oxygen) or O2 (100%). Following meperidine administration, animals were placed into a sealed chamber through which flowed either N2O or O2. Arterial blood was obtained, at baseline and at 15-min intervals, from a femoral artery catheter and pH, O2, CO2 (mm Hg), and oxygen saturation (%) were determined. Plasma samples were analyzed using a System 1306 pH/blood gas analyzer. Group comparisons demonstrated that: (a) N2O coadministration, in animals pretreated with meperidine, did not result in increased arterial CO2 levels, and (b) as expected, arterial O2 levels in all groups increased significantly from preexposure baseline values (P < 0.05). This investigation demonstrated that the coadministration of N2O to meperidine-sedated animals did not enhance respiratory depression.

Analgesics, Opioid↗
PubMed1997

Analgesic effectiveness of ketorolac compared to meperidine in the rat formalin test.

The rat formalin test is an analgesic behavioral observation assessment method that demonstrates two phases of nociceptive behavior. The test consists of injecting the right hind paw with a 5% formalin solution and then observing the animal for specific nociceptive behavior. The phases represent two different types of pain. Phase 1 is pain produced by direct nerve stimulation and phase 2 is an inflammation-induced pain. The nociceptive behavior measured in this experiment was licking and biting the injected paw. A comparison of nociceptive behavior was made when ketorolac and meperidine were injected (i.p.) 10 min prior to formalin injection. As expected, a biphasic pattern of licking and biting the injected paw ensued. It was found that ketorolac had no significant reduction in licking and biting, while meperidine dramatically reduced the nociceptive response in phase 1. In phase 2, both ketorolac and meperidine caused a reduction in licking and biting; however, meperidine reduced the nociceptive response to a greater extent. This experiment demonstrates that ketorolac, when compared to meperidine, is less effective in treating pain from inflammatory origin and is not effective in treating pain from direct nerve stimulation.

Analgesics, Non-Narcotic↗