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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 -
Pain Research & Management 2022Comparing bupivacaine's adjuvants in spinal anesthesia, we assessed the specific blocking characteristics and adverse effects of bupivacaine alone and in combination... (Randomized Controlled Trial)
Randomized Controlled Trial
Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia during Cesarean Section: A Double-Blind Randomized Clinical Trial Study.
BACKGROUND
Comparing bupivacaine's adjuvants in spinal anesthesia, we assessed the specific blocking characteristics and adverse effects of bupivacaine alone and in combination with dexmedetomidine or meperidine in spinal anesthesia during cesarean section.
METHODS
In this double-blind randomized clinical trial study, ninety pregnant women were divided into groups to receive 10 mg bupivacaine (group B), 10 mg bupivacaine with 5 g dexmedetomidine (group BD), or 10 mg bupivacaine with 10 mg meperidine (group BM) intrathecal. Patients were assessed for the quality of analgesia during operations. Durations of sensory and motor blocks and anesthesia-related complications were analyzed using SPSS 21, and values <0.05 were considered statistically significant.
RESULTS
The onset of sensory and motor blocks was essentially the same in all treated groups. Block regression time was significantly prolonged in the BD group compared to the B and BM groups ( < 0.001). The duration of analgesia was significantly longer in the BD and BM groups than in the B group ( < 0.001). The level of sedation in the BD group was higher than in the B group. Shivering occurred in 40% of patients in the B group, which was significantly more than that of the BD (16.6%) and BM (33.3%) groups. Itching happened in 33.3% of women in the BM group which was statistically more than that of the B (3.33%) and BD (0) groups. The incidence of adverse effects was the same in all groups.
CONCLUSION
The combination of bupivacaine with dexmedetomidine significantly prolonged sensory and motor regression time and duration of analgesia.
Topics: Analgesics; Anesthesia, Spinal; Anesthetics, Local; Bupivacaine; Cesarean Section; Dexmedetomidine; Double-Blind Method; Female; Humans; Injections, Spinal; Meperidine; Pain; Pregnancy
PubMed: 35899020
DOI: 10.1155/2022/5111214 -
Journal of Pain and Symptom Management Apr 2014Normeperidine accumulates in patients with impaired renal function and may cause central neurotoxicity. However, some uremic patients still undergo meperidine treatment...
CONTEXT
Normeperidine accumulates in patients with impaired renal function and may cause central neurotoxicity. However, some uremic patients still undergo meperidine treatment for chronic pain.
OBJECTIVES
To prevent normeperidine side effects and complications, we investigated the clearance rate and extraction ratio of meperidine and normeperidine in hemodialysis patients with chronic pain.
METHODS
Three hemodialysis patients, with diagnoses of chronic pancreatitis, chronic back pain, and intractable intra-abdominal pain, received long-term (more than six months) administration of meperidine for chronic noncancer pain. During regular hemodialysis, 72 blood samples in total were collected from the afferent port, efferent port, and ultradiafiltrate port at eight time points. The plasma concentrations of meperidine and normeperidine were determined by high-performance liquid chromatography.
RESULTS
The prehemodialysis plasma concentrations of meperidine and normeperidine were 2963 ± 315 and 2369 ± 1974 ng/mL, which declined to 591 ± 109 and 853 ± 765 ng/mL, with 80% and 65% reduction, respectively. The plasma clearance and extraction ratios of meperidine were 22.7 ± 9.8 mL/minute and 10.1 ± 5.6% and for normeperidine 26.0 ± 11.4 mL/minute and 10.8 ± 2.5%, respectively.
CONCLUSION
Hemodialysis can efficiently remove meperidine and its active metabolite, normeperidine, in uremic patients receiving long-term meperidine therapy for chronic noncancer pain.
Topics: Abdominal Pain; Adult; Analgesics, Opioid; Back Pain; Blood Chemical Analysis; Chromatography, High Pressure Liquid; Chronic Pain; Female; Humans; Male; Meperidine; Metabolic Clearance Rate; Middle Aged; Pancreatitis, Chronic; Renal Dialysis; Time Factors
PubMed: 23870842
DOI: 10.1016/j.jpainsymman.2013.05.007 -
Cirugia Y Cirujanos 2024The aim of this study is to evaluate the effect of erector spinae plane block (ESPB) as a rescue therapy in the recovery room.
OBJECTIVE
The aim of this study is to evaluate the effect of erector spinae plane block (ESPB) as a rescue therapy in the recovery room.
MATERIALS AND METHODS
This single-center historical cohort study included patients who received either ESPB or intravenous meperidine for pain management in the recovery room. Patients' numeric rating scale (NRS) scores and opoid consumptions were evaluated.
RESULTS
One hundred and eight patients were included in the statistical analysis. Sixty-two (57%) patients received ESPB postoperatively (pESPB) and 46 (43%) patients were managed with IV meperidine boluses only (IV). The cumulative meperidine doses administered were 0 (0-40) and 30 (10-80) mg for the pESPB and IV groups, respectively (p < 0.001). NRS scores of group pESPB were significantly lower than those of Group IV on T30 and T60.
CONCLUSION
ESPB reduces the frequency of opioid administration and the amount of opioids administered in the early post-operative period. When post-operative rescue therapy is required, it should be considered before opioids.
Topics: Humans; Male; Female; Middle Aged; Pain, Postoperative; Nerve Block; Paraspinal Muscles; Adult; Meperidine; Analgesics, Opioid; Cohort Studies; Pain Measurement; Aged; Cholecystectomy; Anesthetics, Local; Retrospective Studies
PubMed: 38782375
DOI: 10.24875/CIRU.23000062 -
International Journal of Environmental... Nov 2021Pain relief during labor is a part of standard care in modern obstetrics. Several modalities used for pain relief have their own disadvantages and benefits in terms of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Pain relief during labor is a part of standard care in modern obstetrics. Several modalities used for pain relief have their own disadvantages and benefits in terms of side effects, effectiveness, availability, and satisfaction. The objectives of this study are primarily to compare the effectiveness and patients' satisfaction for pain relief during labor between pethidine and inhaled 50% nitrous oxide (Entonox).
METHODS
Laboring women at 37-41 + 6 weeks of gestation were randomly allocated to receive pethidine (50 mg intravenously) or Entonox for reducing labor pain. Pain scores were evaluated at 0, (baseline), 30, 60, 90, and 120 min after initiation, using the visual analog scale (VAS) and also satisfaction score after delivery using the verbal rating scale (VRS). The secondary outcomes were also assessed, including APGAR scores, labor course, side effects, and cesarean section rate.
RESULTS
A total of 136 laboring women underwent randomization into two groups, but only 58 and 65 in the pethidine group and the Entonox group were available for analysis. The median pain scores at baseline, 30, 60, and 90 min were comparable between both groups (-value > 0.05); however, pain score at 120 min in the pethidine group was significantly higher (-value: 0.038). The median of satisfaction score was significantly higher in the Entonox group (4 vs. 3; -value 0.043). All of the secondary outcomes were comparable between the two groups.
CONCLUSIONS
Both have comparable effectiveness, but Entonox has a higher satisfaction score. Entonox could be an alternative to pethidine for reducing labor pain, because of its efficacy, ease for self-adjustment for satisfaction, and no serious effects on the labor course and newborns.
Topics: Analgesics, Opioid; Cesarean Section; Female; Humans; Infant, Newborn; Labor Pain; Meperidine; Nitrous Oxide; Oxygen; Pregnancy
PubMed: 34886299
DOI: 10.3390/ijerph182312571 -
The Journal of International Medical... 2006Effective pain relief following adenotonsillectomy in children remains a challenge. This study evaluated the effects of intramuscular 0.5 mg/kg ketamine, 1 mg/kg...
Effective pain relief following adenotonsillectomy in children remains a challenge. This study evaluated the effects of intramuscular 0.5 mg/kg ketamine, 1 mg/kg tramadol or 1 mg/kg meperidine on post-operative pain and recovery in 45 children aged 1-7 years undergoing adenotonsillectomy. Anaesthesia was induced with thiopental or sevoflurane (with succinylcholine for intubation) and was maintained with sevoflurane in oxygen and nitrous oxide. Post-operative pain was scored blind using a modified Toddler-Preschooler Post-Operative Pain Scale 30, 60, 120 and 240 min after tracheal extubation. Post-operative agitation scores were also recorded. Mean post-operative pain score was significantly higher in the tramadol-treated group compared with the meperidine-treated group 120 min after extubation. At all other time-points after extubation, mean post-operative pain scores were similar for the three treatment groups. Ketamine was associated with a significantly higher mean agitation score compared with tramadol and meperidine. We conclude that the effects of ketamine, meperidine and tramadol on post-operative pain following adenotonsillectomy in children were similar.
Topics: Analgesics; Child; Child, Preschool; Female; Humans; Infant; Ketamine; Male; Meperidine; Pain, Postoperative; Tonsillectomy; Tramadol
PubMed: 17294997
DOI: 10.1177/147323000603400610 -
Xenobiotica; the Fate of Foreign... Feb 20201. Meperidine is an opioid analgesic that undergoes demethylation to form the neurotoxic metabolite normeperidine. Previous studies indicate that meperidine...
1. Meperidine is an opioid analgesic that undergoes demethylation to form the neurotoxic metabolite normeperidine. Previous studies indicate that meperidine -demethylation is catalyzed by cytochrome P450 2B6 (CYP2B6), CYP3A4, and CYP2C19.2. The purpose of this study was to examine the relative P450 contributions to meperidine -demethylation and to evaluate the effect of polymorphism on normeperidine generation. Experiments were performed using recombinant P450 enzymes, selective chemical inhibitors, enzyme kinetic assays, and correlation analysis with individual -genotyped human liver microsomes.3. The catalytic efficiency (/) for meperidine -demethylation was similar between recombinant CYP2B6 and CYP2C19, but markedly lower by CYP3A4.4. In -genotyped human liver microsomes, normeperidine formation was significantly correlated with CYP2C19 activity (-mephenytoin 4-hydroxylation).5. CYP2C19 inhibitor (+)--3-benzylnirvanol and CYP3A inhibitor ketoconazole significantly reduced microsomal normeperidine generation by an individual donor with high CYP2C19 activity, whereas donors with lower CYP2C19 activity were sensitive to inhibition by ketoconazole but not benzylnirvanol.6. These findings demonstrate that the relative CYP3A4, CYP2B6, and CYP2C19 involvement in meperidine -demethylation depends on the enzyme activities in individual human liver microsomal samples. CYP2C19 is likely an important contributor to normeperidine generation in individuals with high CYP2C19 activity, but additional factors influence inter-individual metabolite accumulation.
Topics: Cholinesterase Inhibitors; Cytochrome P-450 CYP2C19; Cytochrome P-450 Enzyme System; Demethylation; Humans; Meperidine; Mephenytoin
PubMed: 30902024
DOI: 10.1080/00498254.2019.1599465 -
Medical Science Monitor : International... May 2013The efficacy of epidural anesthesia and analgesia in management of perioperative stress has been established. Perioperative pain management strategies decrease surgical... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
The efficacy of epidural anesthesia and analgesia in management of perioperative stress has been established. Perioperative pain management strategies decrease surgical complications and aid recovery. In this study, we aimed to document and compare the efficacy of epidural bupivacaine and intravenous meperidine on recovery of patients with elective abdominal aortic surgery performed under general anesthesia.
MATERIAL AND METHODS
Patients undergoing elective abdominal aortic surgery between February 2009 and November 2011 were studied prospectively. Patients were randomized into epidural bupivacaine (n=40) and intravenous meperidine (n=40) groups regarding postoperative analgesia strategy. The preoperative demographic characteristics, perioperative outcomes, postoperative adverse effects of analgesia strategy, time to initiate oral intake, sedation scores, visual analogue scale results, and mobility scores were compared.
RESULTS
The mean ages of the patients were 61.7±8.1 in the epidural group and 59.4±9.7 in the intravenous group (p>0.05). The preoperative demographic characteristics of the patients were comparable between the groups. There were no statistically significant differences between groups regarding anesthesia times, intubation times, intensive care unit stay, hospital length of stay, postoperative vomiting, and postoperative cardiac, renal, and cerebral complications. Postoperative nausea was more prevalent in the meperidine group (p<0.05). In the epidural group, time to begin oral intake was shorter, sedation scores and visual analogue scale results were lower, and mobility scores were higher (p<0.05 each).
CONCLUSIONS
Epidural analgesia allowed earlier recovery compared to intravenous analgesia in patients undergoing elective abdominal aortic surgery, but did not affect postoperative outcomes and complications.
Topics: Analgesia, Epidural; Aorta, Abdominal; Bupivacaine; Demography; Elective Surgical Procedures; Female; Humans; Injections, Intravenous; Male; Meperidine; Middle Aged; Perioperative Care; Recovery of Function; Treatment Outcome
PubMed: 23666275
DOI: 10.12659/MSM.889005 -
Anesthesiology Feb 1987The experiments examined the characteristics of analgesia produced by different doses of morphine, meperidine (pethidine), fentanyl, and sufentanil after epidural and...
The experiments examined the characteristics of analgesia produced by different doses of morphine, meperidine (pethidine), fentanyl, and sufentanil after epidural and subcutaneous injection in rats. The specificity of the analgesia was also determined; other in vivo pharmacologic activities (i.e., blockade of pinna and cornea reflexes and production of skeletal muscle rigidity) were monitored as pharmacologic indices of opiate drug activity in the brain. After subcutaneous injection, the opiates produced dose-dependent analgesia, blocked the pinna and cornea reflexes, and induced muscle rigidity. After epidural injection, all four compounds produced dose-dependent analgesia and had greater potency, earlier onset, shorter duration, and greater specificity of analgesic action than was the case after subcutaneous injection. Specificity is defined here as the ratio of the ED50 dose that blocked the pinna reflex to the ED50 dose that produced analgesia. The gains in potency and specificity, but not the gains in onset time and the losses in duration of analgesia, differed considerably among the compounds that were examined. The subcutaneous-to-epidural potency ratio related in a linear manner with the lipid-to-water partition coefficient. The gain in specificity also appeared to be related to lipid solubility. The microgram X kg-1 doses at which the opiates produced analgesia in rats correlate well with the potency of these compounds in producing analgesia after epidural injection in humans. The rat epidural preparation reflected the doses, onset, and specificity, but not the duration, of analgesia produced by epidural opiates in humans.
Topics: Analgesia; Animals; Cornea; Fentanyl; Injections, Epidural; Injections, Subcutaneous; Male; Meperidine; Morphine; Rats; Rats, Inbred Strains; Sufentanil; Time Factors
PubMed: 2949676
DOI: 10.1097/00000542-198702000-00013