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Meperidine

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1621. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women's Anesthesia Research Group. (Abstract)

Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women's Anesthesia Research Group. The combined spinal-epidural (CSE) technique using bupivicaine-fentanyl has become an established method of pain control during parturition. One limitation is the relatively short duration of effective analgesia produced by bupivicaine-fentanyl. In contrast, subarachnoid meperidine has been shown to provide a long duration of anesthesia in nonobstetric patients (...) . Therefore, the authors tested the hypothesis that subarachnoid meperidine produces a significant increase in the duration of analgesia compared with bupivicaine-fentanyl.Based on a power analysis of preliminary data, the authors intended to recruit 90 patients for the study, randomized to three groups: 2.5 mg bupivicaine-25 microg fentanyl, 15 mg meperidine, or 25 mg meperidine. However, after enrolling 34 patients, the study was discontinued because of a significant increase in nausea or vomiting

2000 Anesthesiology Controlled trial quality: uncertain

1622. Ketorolac versus meperidine: ED treatment of severe musculoskeletal low back pain. (Abstract)

Ketorolac versus meperidine: ED treatment of severe musculoskeletal low back pain. The study objective was to assess the efficacy and patient acceptance of ketorolac as an alternative to meperidine for the treatment of severe musculoskeletal low back pain (LBP). A double blinded prospective trial in a convenience sample of patients >18 years of age presenting to an urban university hospital emergency department (ED) was conducted over a 19-month period. Patients were included if the pain (...) was musculoskeletal in origin and was severe enough to warrant parenteral analgesics. Patients were randomized to receive 1 mg/kg meperidine intramuscularly (IM) or 60 mg ketorolac IM. Pain intensity was measured preadministration and at 60 minutes via a 100 mm Visual Analog Scale (VAS). Outcomes measured at 60 minutes were pain intensity decrease (PID), patient satisfaction, rescue analgesia requirement, sedation level, and adverse effects. Clinically significant pain reduction was defined as a PID of at least

2000 American Journal of Emergency Medicine Controlled trial quality: predicted high

1623. Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy. (Abstract)

Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy. Adequate relief of pain after tonsillectomy is a common problem. We compared meperidine and tramadol when given at induction of anaesthesia with respect to their effects on postoperative pain relief and emergence characteristics after adenotonsillectomy in children.Fifty children aged 4-7 yr undergoing tonsillectomy were randomly assigned to receive either tramadol 1 mg kg(-1) (n = 25 (...) ) or meperidine 1 mg kg(-1) (n = 25) before commencement of the surgical procedure. Anaesthesia was induced with propofol (with cis-atracurium for muscle relaxation) and maintained with sevoflurane in oxygen and nitrous oxide. Postoperative pain was scored by a blinded observer using a facial pain scale in the recovery room at 0 (at arrival of the patient in the postoperative care unit) and at 10, 20 and 45 min thereafter. Agitation scores were also assessed by the same observer at 0 min. Heart rate and mean

2003 European Journal of Anaesthesiology Controlled trial quality: uncertain

1624. Comparison of the efficacy of oral midazolam alone versus midazolam and meperidine in the pediatric dental patient. (Abstract)

Comparison of the efficacy of oral midazolam alone versus midazolam and meperidine in the pediatric dental patient. The purpose of this study was to compare midazolam alone (Group A: 1 mg/kg) vs midazolam plus meperidine (Group B: 0.5 and 1 mg/kg, respectively) in regard to physiology and behavior of young children sedated for dental restorative care.Twenty healthy children who met selection criteria were randomly assigned to 1 of 2 groups and subsequently treated in a prospective, crossover (...) administration.Oral midazolam alone is just as effective as midazolam with meperidine. Disruptive behaviors accounted for increased heart rates.

2003 Pediatric dentistry Controlled trial quality: uncertain

1625. Plasma concentrations of meperidine and normeperidine following continuous intrathecal meperidine in patients with neuropathic cancer pain. (Abstract)

Plasma concentrations of meperidine and normeperidine following continuous intrathecal meperidine in patients with neuropathic cancer pain. Intrathecal administration of meperidine, an opioid with local anesthetic activity, can induce analgesia in patients with intractable cancer pain. However, continuous intrathecal administration may result in the accumulation of normeperidine, responsible for central nervous system toxicity.Ten patients with neuropathic cancer pain, not responding (...) to conventional opioid therapy, were treated with continuous intrathecal administration of meperidine. In all patients, plasma concentrations of meperidine and normeperidine were measured the first days after the start of treatment. Visual analog scale scores were recorded to evaluate pain relief. Quality of life was assessed before and 3 weeks following the start of intrathecal treatment.In three patients the plasma concentrations of meperidine and normeperidine increased rapidly. In one patient the plasma

2005 Acta Anaesthesiologica Scandinavica

1626. Meperidine is alive and well in the new millennium: evaluation of meperidine usage patterns and frequency of adverse drug reactions. (Abstract)

Meperidine is alive and well in the new millennium: evaluation of meperidine usage patterns and frequency of adverse drug reactions. To report a classic case of normeperidine toxicity, and to present institution-specific data on meperidine usage patterns and the frequency of adverse drug reactions (ADRs).A chart review was conducted of patients at high risk for ADRs. High-risk patients were identified through the pharmacy computer system as those with renal insufficiency (creatinine clearance (...) < or = 50 ml/min), those receiving meperidine with patient-controlled analgesia (PCA), or those receiving more than 200 mg/day of intravenous meperidine for multiple days.Twenty-five percent of patients who received meperidine had some degree of renal insufficiency. The average daily dose of meperidine was 230 mg; cumulative doses ranged from 10-7200 mg. Adverse drug reactions documented in 20 (14%) of 141 patients were confusion, anxiety, nervousness, hallucinations, twitching, and seizure. Sixteen

2004 Pharmacotherapy

1627. A prospective study of 2 sedation regimens in children: chloral hydrate, meperidine, and hydroxyzine versus midazolam, meperidine, and hydroxyzine. Full Text available with Trip Pro

A prospective study of 2 sedation regimens in children: chloral hydrate, meperidine, and hydroxyzine versus midazolam, meperidine, and hydroxyzine. The aim of this study was to compare both the behavioral and physiological effects of 2 drug regimens in children: chloral hydrate (CH), meperidine (M), and hydroxyzine (H) (regimen A) versus midazolam (MZ), M, and H (regimen B). Patients between 24 and 54 months of age were examined by crossover study design. Behavior was analyzed objectively

2006 Anesthesia progress Controlled trial quality: uncertain

1628. A comparison of the haemodynamic effects of intrathecal meperidine, meperidine-bupivacaine mixture and hyperbaric bupivacaine. Full Text available with Trip Pro

A comparison of the haemodynamic effects of intrathecal meperidine, meperidine-bupivacaine mixture and hyperbaric bupivacaine. To study the haemodynamic effects of intrathecal meperidine, administered either alone or mixed with bupivacaine.We studied 42 Chinese patients, aged 59-87 yr, scheduled for transurethral bladder or prostate surgery, randomized into three equals groups, that received either meperidine 0.8 mg.kg-1, meperidine 0.4 mg.kg-1 plus 1.5 ml of 0.5% heavy bupivacaine or 3 ml (...) of heavy bupivacaine 0.5%. Non-invasive systolic (SAP) and mean (MAP) arterial pressures, central venous pressure and cardiac index, stroke index and heart rate (HR) measured by the BoMed NCCOM3-R7S bioimpedance device, were recorded over the first 25 min. Systemic vascular resistance index (SVRI) was derived. Onset of sensory and motor block was also measured. Decreases in MAP of 25% were treated with colloid and metaraminol.The onset of block was slower in the meperidine group (P < 0.05). Decreases

1996 Canadian journal of anaesthesia = Journal canadien d'anesthesie Controlled trial quality: uncertain

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