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Meperidine

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142. Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient

. However, related research in other populations may be extrapolated to the setting of therapeutic hypothermia following cardiac arrest. In an open-label randomized study of 20 patients following hypothermic cardiopulmonary bypass, vecuronium (0.1 mg/kg bolus followed by 1 µg·kg –1 ·min –1 for 4 hr) eliminated shivering in 100% of patients, compared with 50% of patients who received meperidine (25 mg every 15 min until no shivering was observed or a total dose of 75 mg was administered) ( p < 0.05 (...) ) ( ). Vecuronium eliminated shivering without lowering systolic blood pressure, as occurred with meperidine ( p < 0.02), and eliminated shivering in the five patients whose shivering was uncontrolled by meperidine. As was noted in nonrandomized studies involving pancuronium for the prevention of shivering in patients following cardiopulmonary bypass ( , ), vecuronium administration was associated with consistent and statistically significant decreases in oxygen consumption and CO 2 production, effects not seen

2016 Society of Critical Care Medicine

143. Liver Disease and Pregnancy

recommendation, low level of evidence). Computed tomography scans carry a risk of teratogenesis and childhood hematologic malignancies but may be used judiciously with minimized radiation protocols (2–5 rads; conditional recommendation, very low level of evidence). Endoscopy in pregnancy Endoscopy is safe in pregnancy but should be deferred until the second trimester if possible (strong recommendation, low level of evidence). Meperidine and propofol can be used for endoscopic sedation (strong recommendation (...) trimester if possible (strong recommendation, low level of evidence). 6. Meperidine and propofol can be used for endoscopic seda- tion (strong recommendation, moderate level of evidence). Although clinical studies on the safety and eff ectiveness of endoscopy for the pregnant patient have been limited, endo- scopy can be safe and eff ective if careful assessment of the risks, benefi ts, and clinical rationale is performed. One of the most important clinical issues in endoscopy of the pregnant patient

2016 American College of Gastroenterology

144. Perinatal substance use: maternal

to online version, destroy printed copies after use Page 7 of 29 1.2 Commonly used/misused substances Table 2. Substances commonly used/misused Opioids 5 (CNS depressants) Agonists 5 • Codeine 9 • Fentanyl • Heroin (Diacetyl morphine/Diamorphine) • Hydromorphone • Morphine • Methadone • Meperidine • Oxycodone • Propoxyphene Antagonists • Naltrexone Mixed agonist–antagonists • Buprenorphine (Subutex) 9 • Butorphanol • Nalbuphine • Pentazocine CNS stimulants Psycho stimulants • Caffeine 5 • Cocaine 5,9,10

2016 Queensland Health

145. Opioids for agitation in dementia. (PubMed)

Improvement Group Specialized Register, on 13 June 2014 using the terms: narcotic OR opioid OR opium OR morphine OR buprenorphine OR codeine OR dextromoramide OR diphenoxylate OR dipipanone OR dextropropoxyphene OR propoxyphene OR diamorphine OR dihydrocodeine OR alfentanil OR fentanyl OR remifentanil OR meptazinol OR methadone OR nalbuphine OR oxycodone OR papaveretum OR pentazocine OR meperidine OR pethidine OR phenazocine OR hydrocodone OR hydromorphone OR levorphanol OR oxymorphone OR butorphanol

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2015 Cochrane

146. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication (PubMed)

were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject's anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy.Groups (...) were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1-10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group.Premedication with Meperidine or Midazolam in PLB would improve patients' tolerance, comfort

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2017 Euroasian journal of hepato-gastroenterology

147. Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy (PubMed)

Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function.A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10 (...) , advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs. In group MM, 2 mg midazolam and 20 mg meperidine was given intravenously and additional 1 to 2 mg midazolam and 20 mg meperidine (with a maximum total of 5 mg midazolam and 50 mg meperidine) was given when bispectral index (BIS) was >80. In group RP, 100 μg/kg/minute propofol infusion and 1 μg/kg remifentanil bolus was administered and additional 0.5 μg/kg remifentanil bolus

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2017 Euroasian journal of hepato-gastroenterology

149. Narcotics, Benzodiazepines, Stimulants, and Gabapentin: Policies, Initiatives, and Practices Across Canada, 2014

to the province’s PRP include, but are not limited to: select narcotic and controlled drugs, such as methadone and hydromorphone amphetamines anabolic steroids barbiturates benzodiazepines buprenorphine chloral hydrate codeine-containing products diethylpropion gabapentin. Increasing reports from law enforcement agencies on the sale and seizure of gabapentin prompted the addition of this substance to the list of monitored drugs. The province also identified safety concerns around meperidine and pentazocine

2015 Canadian Agency for Drugs and Technologies in Health - Environmental Scanning

150. Anaesthetic Agents in Pregnant Women Undergoing Non-Obstetric Surgical or Endoscopic Procedures

was performed during the first trimester of pregnancy. The non- randomized study concluded that regional anaesthesia for laparotomic adnexal mass surgery during pregnancy may be associated with an increased risk of preterm labour. However, it is difficult to elucidate the impact of anaesthesia alone on pregnancy outcomes due to the influence of several confounding factors present in the included studies. One evidence-based guideline was identified that recommends meperidine as the preferred agent (...) and lactating women, including recommendations for the use of analgesics and anaesthetic agents. Based on what was classified as very low quality evidence from “two large studies” otherwise undefined, ASGE recommends meperidine as the preferred agent for procedures on pregnant women requiring moderate sedation. They also recommend that deep sedation should be administered by an anaesthesia provider; however, no guidance on specific agents was included in this recommendation. A general procedural

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

153. Comparison of intraperitoneal versus intravenous dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: a randomized clinical trial. (PubMed)

common side effects in the IV dexamethasone group. The groups did not differ significantly in terms of mean VAS score for pain and total meperidine consumption during the first 24 h postoperatively.Intraperitoneal dexamethasone at a dose of 8 mg at the end of gynecological laparoscopy reduces the incidence of postoperative nausea.

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2019 Korean journal of anesthesiology

154. The effects of novel α (PubMed)

The effects of novel α Objective: 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).Methods: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, n=50) and meperidine positive control (...) group (Group M, n=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 O2 saturation, tympanic temperature, and sedation score.Results: Dexmedetomidine provided similar anti-shivering effects

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2019 Bioscience reports

155. Risk factors for postoperative delirium in patients undergoing lower extremity joint arthroplasty: a retrospective population-based cohort study. (PubMed)

data from the all-payer Premier Healthcare database containing detailed billing information from >25% nationwide hospitalizations. Patients undergoing elective total hip/knee arthroplasty surgery (2006-2016) were included.The primary outcome was postoperative delirium, while potential risk factors included age, gender, race, insurance type, and modifiable exposures including anesthesia type, opioid prescription dose (low/medium/high), benzodiazepines, meperidine, non-benzodiazepine hypnotics

2019 Regional Anesthesia and Pain Medicine

156. Opioid Management in Older Adults with Chronic Kidney Disease: A Review. (PubMed)

, transdermal buprenorphine, transdermal fentanyl, and oral hydromorphone are the most tolerable opioids in these patients; hydrocodone, oxycodone, and methadone are useful but require careful monitoring; and tramadol, codeine, morphine, and meperidine should be avoided due to risk of accumulation and adverse events. Because older adults with nondialysis chronic kidney disease are at increased risk for adverse events, vigilant monitoring of opioid prescription is critical. Lastly, collaboration among

2019 American Journal of Medicine

157. Evaluation of the P-glycoprotein (Abcb1) affinity status of a series of morphine analogs: Comparative study with meperidine analogs to identify opioids with minimal P-glycoprotein interactions (PubMed)

Evaluation of the P-glycoprotein (Abcb1) affinity status of a series of morphine analogs: Comparative study with meperidine analogs to identify opioids with minimal P-glycoprotein interactions One of the major shortcomings of many commonly used opioids is the fact that they are P-gp substrates, which represents a major obstacle towards effective pain management. P-gp can affect opioids' oral absorption, CNS accumulation, systemic clearance, antinociceptive activity, and tolerance development (...) meperidine analogs. The fold stimulation of the morphine analogs ranged from 1.01 to 1.54 while for the meperidine analogs the fold stimulation ranged from 1.10 to 3.66. From each series (morphine and meperidine analogs) we selected potential candidate opioids that are non-P-gp substrates and conducted in vivo assessments of their antinociceptive effects using P-gp knockout and P-gp competent mice. 6-Desoxymorphine, meperidine and N-phenylbutyl normeperidine did not significantly (p>0.05) stimulate

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2009 International journal of pharmaceutics

158. Propofol alone versus propofol in combination with meperidine for sedation during colonoscopy. (PubMed)

Propofol alone versus propofol in combination with meperidine for sedation during colonoscopy. Despite the increasing popularity of propofol for sedation in colonoscopy, the optimal regimen is still controversial. Both propofol alone and propofol in combination with meperidine are frequently used during colonoscopy, but the impact of adding meperidine has not been evaluated. This study aimed to investigate if adding meperidine to propofol offers any advantage in terms of patient tolerance (...) , recovery time, and postcolonoscopy discomforts.Consecutive patients admitted to the physical checkup department of our hospital were randomized to receive either meperidine plus propofol (combination group, n=100) or propofol alone (propofol group, n=100) for sedated colonoscopy. The patients' tolerance and postcolonoscopy discomforts (pain, bloating, dizziness, and nausea/vomiting) were assessed with a 0-10 visual analog scale. The recovery times were assessed with 5-minute and 10-minute Aldrete

2009 Journal of clinical gastroenterology

159. Clinical trial: a randomized, study comparing meperidine (pethidine) and fentanyl in adult gastrointestinal endoscopy. (PubMed)

Clinical trial: a randomized, study comparing meperidine (pethidine) and fentanyl in adult gastrointestinal endoscopy. There is little evidence to guide choice between meperidine (pethidine) and fentanyl for sedation for gastrointestinal endoscopy.To compare meperidine with fentanyl in terms of procedure time and analgesia.Single centre randomized controlled trial. Patients received narcotic doses and midazolam at the discretion of the attending endoscopist who was unaware of narcotic (...) assignment. Endoscopy and recovery times were then recorded. The main outcome was total procedure time, defined as endoscopy time plus recovery time. Patient discomfort was assessed prior to discharge via visual analogue scale (VAS).In total, 55 patients were randomized to meperidine [44 colonoscopy and 11 esophagogastroduodenoscopy (EGD)] and 56 to fentanyl (45 colonoscopy and 11 EGD). Total procedure time was shorter for those receiving fentanyl (mean = 87.7 min) than for those receiving meperidine

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2009 Alimentary pharmacology & therapeutics

160. Meperidine versus valethamate bromide in shortening the duration of active labor. (PubMed)

Meperidine versus valethamate bromide in shortening the duration of active labor. To compare the efficacy and safety of meperidine hydrochloride and valethamate bromide against placebo in shortening the duration of active labor.We randomly assigned 160 nulliparous women with a singleton pregnancy at term who needed induction of labor to one of 3 treatments: 50 mg of meperidine (n=53), 16 mg of valethamate bromide (n=53), or a normal saline solution as placebo (n=54). All medications were given (...) by slow intravenous infusion. Labor duration was the main outcome measure.The intervals between infusion and complete cervical dilation and between infusion and delivery were significantly reduced (P<0.001 and P<0.01) in the meperidine group (103.0+/-64.5 minutes and 119.8+/-70.2 minutes), in contrast to the placebo group (173.9+/-74.8 minutes and 192.2+/-82.8 minutes). However, differences were not significant between the 2 treatment groups (139.6+/-63.1 minutes and 160.6+/-71.9 minutes), or between

2009 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

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