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Acta Cirurgica Brasileira 2020To evaluate the effects of meperidine on fascial healing.
PURPOSE
To evaluate the effects of meperidine on fascial healing.
METHODS
Seventy adult male Sprague-Dawley rats divided into 7 groups with 10 rats in each group. One of these groups was determined as the sham group, 3 of the remaining 6 groups as meperidine groups, and 3 as control groups. These were grouped as 1st, 2nd, and 6th weeks. In the anterior abdominal wall of the rat, the skin was detached and a wound model including the peritoneum was created with a median incision. Mice in the meperidine group were injected with meperidine intraperitoneally (IP) 3 × 20 mg/kg meperidine on postoperative days 0, 1 and 2, and 2 × 20 mg/kg meperidine on postoperative days 3, 4, 5, and 6 after surgical intervention. Similar to the control group, an equal volume of saline was administered, corresponding to the doses. After sacrifice, the midline fascia was used for facial tensile strength measurement, and the other for histopathological analysis.
RESULTS
When compared, the meperidine and control groups inflammatory cell density was higher in the 1st week (p < 0.05) in the meperidine group, fibroplasia density was found to be higher at the 2nd week in the meperidine group than the control group (p < 0.05) When the tensile strength in the meperidine and control groups were compared, there was no significant difference (p > 0.05) at each of the three weeks.
CONCLUSION
The application of postoperative systemic meperidine affects positively wound healing in the inflammatory stage and fibroplasia without changing the resistance to traction.
Topics: Animals; Fascia; Male; Meperidine; Mice; Rats; Rats, Sprague-Dawley; Skin; Tensile Strength; Wound Healing
PubMed: 33331457
DOI: 10.1590/ACB351107 -
Critical Care (London, England) 2007Mild therapeutic hypothermia has been shown to improve outcome for patients after cardiac arrest and may be beneficial for ischaemic stroke and myocardial ischaemia... (Clinical Trial)
Clinical Trial
INTRODUCTION
Mild therapeutic hypothermia has been shown to improve outcome for patients after cardiac arrest and may be beneficial for ischaemic stroke and myocardial ischaemia patients. However, in the awake patient, even a small decrease of core temperature provokes vigorous autonomic reactions-vasoconstriction and shivering-which both inhibit efficient core cooling. Meperidine and skin warming each linearly lower vasoconstriction and shivering thresholds. We tested whether a combination of skin warming and a medium dose of meperidine additively would reduce the shivering threshold to below 34 degrees C without producing significant sedation or respiratory depression.
METHODS
Eight healthy volunteers participated on four study days: (1) control, (2) skin warming (with forced air and warming mattress), (3) meperidine (target plasma level: 0.9 mug/ml), and (4) skin warming plus meperidine (target plasma level: 0.9 mug/ml). Volunteers were cooled with 4 degrees C cold Ringer lactate infused over a central venous catheter (rate asymptotically equal to 2.4 degrees C/hour core temperature drop). Shivering threshold was identified by an increase of oxygen consumption (+20% of baseline). Sedation was assessed with the Observer's Assessment of Alertness/Sedation scale.
RESULTS
Control shivering threshold was 35.5 degrees C +/- 0.2 degrees C. Skin warming reduced the shivering threshold to 34.9 degrees C +/- 0.5 degrees C (p = 0.01). Meperidine reduced the shivering threshold to 34.2 degrees C +/- 0.3 degrees C (p < 0.01). The combination of meperidine and skin warming reduced the shivering threshold to 33.8 degrees C +/- 0.2 degrees C (p < 0.01). There were no synergistic or antagonistic effects of meperidine and skin warming (p = 0.59). Only very mild sedation occurred on meperidine days.
CONCLUSION
A combination of meperidine and skin surface warming reduced the shivering threshold to 33.8 degrees C +/- 0.2 degrees C via an additive interaction and produced only very mild sedation and no respiratory toxicity.
Topics: Adult; Hot Temperature; Humans; Hypothermia, Induced; Meperidine; Narcotics; Shivering; Skin Temperature; Vasoconstriction
PubMed: 17316456
DOI: 10.1186/cc5709 -
European Journal of Pharmacology Jul 2010Topical analgesics have many potential advantages over systemic administration. Prior work has shown potent analgesic activity of a number of topical opioids in the...
Topical analgesics have many potential advantages over systemic administration. Prior work has shown potent analgesic activity of a number of topical opioids in the radiant heat tail-flick assay. The current study confirms the analgesic activity of morphine and extends it to two other mu opioids, methadone and meperidine. Combinations of topical morphine and lidocaine are synergistic. Similarly, the combination of methadone and lidocaine is synergistic. While there appeared to be some potentiation with the combination of meperidine and lidocaine, it did not achieve significance. Systemically, prior studies have shown that co-administration of morphine and methadone was synergistic. The combination of morphine and methadone was also synergistic when given topically. In contrast, the combination of morphine and meperidine was not synergistic systemically and it was not synergistic topically. Thus, the pharmacology of topical opioids mimics that seen with systemic administration. Their activity in the topical model supports their potential utility while the local limitation of their actions offers the possibility of a reduced side-effect profile.
Topics: Administration, Cutaneous; Analgesics; Animals; Dose-Response Relationship, Drug; Drug Synergism; Lidocaine; Male; Meperidine; Methadone; Mice; Mice, Inbred Strains; Morphine; Pain Measurement
PubMed: 20433826
DOI: 10.1016/j.ejphar.2010.04.020 -
Bioorganic & Medicinal Chemistry Dec 2010A series of benzyl esters of meperidine and normeperidine were synthesized and evaluated for binding affinity at serotonin, dopamine and norepinephrine transporters. The...
A series of benzyl esters of meperidine and normeperidine were synthesized and evaluated for binding affinity at serotonin, dopamine and norepinephrine transporters. The 4-methoxybenzyl ester 8b and 4-nitrobenzyl ester 8c in the meperidine series and 4-methoxybenzyl ester 14a in the normeperidine series exhibited low nanomolar binding affinities at the SERT (K(i) values <2nM) and high SERT selectivity (DAT/SERT >1500 and NET/SERT >1500).
Topics: Esters; Ligands; Meperidine; Serotonin Plasma Membrane Transport Proteins; Selective Serotonin Reuptake Inhibitors; Structure-Activity Relationship
PubMed: 20980153
DOI: 10.1016/j.bmc.2010.09.060 -
Anesthesiology Feb 2002
Review
Topics: Adjuvants, Anesthesia; Anesthesia; Animals; Body Temperature Regulation; Brain; Humans; Intraoperative Complications; Meperidine; Shivering
PubMed: 11818783
DOI: 10.1097/00000542-200202000-00036 -
Anesthesiology Jul 1998BACKGROUND. Meperidine (pethidine) reportedly treats postoperative shivering better than equianalgesic doses of other mu-receptor agonists. The authors' first goal was... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
UNLABELLED
BACKGROUND. Meperidine (pethidine) reportedly treats postoperative shivering better than equianalgesic doses of other mu-receptor agonists. The authors' first goal was to develop a method to accurately determine postoperative shivering thresholds, and then to determine the extent to which meperidine and sufentanil inhibit postoperative shivering.
METHODS
A computer-controlled infusion was started before operation in 30 patients, with target plasma concentrations of 0.15, 0.30, or 0.60 microg/ml meperidine or 0.1, 0.15, or 0.2 ng/ ml sufentanil targeted; patients were randomly assigned to each drug and concentration. The infusion was continued throughout surgery and recovery. Anesthesia was maintained with nitrous oxide and isoflurane. Core temperatures were approximately 34 degrees C by the end of surgery. The compensated core temperature at which visible shivering and a 20% decrease in steady-state oxygen consumption was recorded identified the shivering threshold. A blood sample for opioid concentration was obtained from each patient at this time. The ability of each opioid to reduce the shivering threshold was evaluated using linear regression.
RESULTS
End-tidal isoflurane concentrations were <0.2% in each group at the time of extubation, and shivering occurred approximately 1 h later. Meperidine linearly decreased the shivering threshold: threshold (degrees C) = -2.8 x [meperidine (microg/ml)] + 36.2; r2 = 0.64, P = 0.0005. Sufentanil also linearly decreased the shivering threshold: threshold (degrees C) = -7.8 x [sufentanil (ng/ ml)] + 36.9; r2 = 0.46, P = 0.02.
CONCLUSIONS
At a given dose, sufentanil inhibited shivering 2,800 times better than meperidine. However, the equianalgesic ratio of these drugs is approximately 4,900. That is, meperidine inhibited shivering better than would be expected based on the equianalgesic potency ratio. These data are thus consistent with clinical observations suggesting that meperidine indeed possesses special antishivering activity.
Topics: Adult; Analgesics, Opioid; Humans; Infusions, Intravenous; Meperidine; Middle Aged; Orthopedics; Postoperative Complications; Shivering; Sufentanil
PubMed: 9667292
DOI: 10.1097/00000542-199807000-00009 -
Bioscience Reports Feb 2019Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor... (Randomized Controlled Trial)
Randomized Controlled Trial
Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia (CSEA). 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, =50) and meperidine positive control group (Group M, =50). Primiparas experienced shivering that continued to cord clamping were treated with dexmedetomidine (0.5 μg/kg) or meperidine (0.5 mg/kg) after cord clamping. The primary outcome measures were incidence of nausea, vomiting, and respiratory depression. Secondary outcome measures were shivering score, vital signs including blood pressure, heart rate and O saturation, tympanic temperature, and sedation score. Dexmedetomidine provided similar anti-shivering effects as meperidine in patients after caesarean delivery under CSEA, evidenced as all shivering primiparas responded to either dexmedetomidine or meperidine treatment within 15 min. However, incidence of nausea and vomiting were significantly lower after dexmedetomidine treatment, accompanied with more stable blood pressure. Dexmedetomidine also provided well regulation of tympanic temperature and good sedation. Selective α-adrenoreceptor agonist dexmedetomidine has a better safety profile compared with meperidine for anti-shivering in primiparas undergoing caesarean delivery. Dexmedetomidine could be a better choice for anti-shivering in patients requiring caesarean section. The mechanism of anti-shivering for dexmedetomidine may relate to well regulation of temperature and good sedation.
Topics: Administration, Intravenous; Adrenergic alpha-2 Receptor Agonists; Adult; Anesthesia, Epidural; Anesthesia, Spinal; Body Temperature Regulation; Cesarean Section; Dexmedetomidine; Double-Blind Method; Female; Humans; Meperidine; Postoperative Care; Pregnancy; Shivering; Treatment Outcome
PubMed: 30643009
DOI: 10.1042/BSR20181847 -
The Cochrane Database of Systematic... Jul 2007Pethidine is the most widely used intra-muscular opioid for the relief of labour pain. However concerns have been raised about its effectiveness and the possibility of... (Review)
Review
BACKGROUND
Pethidine is the most widely used intra-muscular opioid for the relief of labour pain. However concerns have been raised about its effectiveness and the possibility of depressing respiration in newborns.
OBJECTIVES
The objective of this review was to assess the effects of different opioids (and different doses of the same opioid) administered intra-muscularly in labour.
SEARCH STRATEGY
We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register (Cochrane Library, issue 4, 1997) and reference lists of articles.
SELECTION CRITERIA
Randomised trials comparing the effects of different currently used opioids (and different doses of the same opioid) administered intramuscularly in labour for women who request systemic analgesia.
DATA COLLECTION AND ANALYSIS
Two reviewers assessed trial quality and extracted data. Analysis was based on the groups as randomly allocated.
MAIN RESULTS
Sixteen trials were included. There were problems with methodological quality of some of the trials, and lack of consistency in the way various outcomes were reported. There was no evidence of a difference between pethidine and tramadol in terms of pain relief, interval to delivery, or instrumental or operative delivery. There appeared to be more adverse effects such as nausea and vomiting and drowsiness with pethidine. Maternal pain relief seemed almost identical between the meptazinol and pethidine groups, whether assessed as maternal satisfaction with pain relief, visual analogue scales, or use of other pain relief, but meptazinol gave rise to slightly more side effects. Maternal satisfaction with pain relief appeared similar for pentazocine and pethidine, with more frequent nausea and vomiting with pethidine.
AUTHORS' CONCLUSIONS
There is not enough evidence to evaluate the comparative efficacy and safety of the various opioids used for analgesia in labour.
Topics: Analgesia, Obstetrical; Analgesics, Opioid; Female; Humans; Injections, Intramuscular; Labor, Obstetric; Meperidine; Pain; Pregnancy
PubMed: 17636658
DOI: 10.1002/14651858.CD001237.pub2 -
Anaesthesia Oct 1979
Topics: Humans; Ketamine; Meperidine; Pain, Postoperative
PubMed: 532934
DOI: 10.1111/j.1365-2044.1979.tb08557.x -
British Medical Journal Nov 1978
Topics: Analgesics; Humans; Infusions, Parenteral; Injections, Intramuscular; Meperidine; Pain, Postoperative
PubMed: 719499
DOI: 10.1136/bmj.2.6150.1499-b