Epidural Pethidine: Pharmacology and Clinical Experience

Pethidine is an effective epidural opioid for the treatment of acute pain. Its use has been well described in Australian and New Zealand practice, particularly in the field of obstetric anaesthesia. Reported methods of delivery have included bolus injection, continuous infusion and patient-controlled epidural analgesia. Areas of application have included treatment of postoperative pain, labour pain and intraoperative pain. Because of its intermediate lipid solubility, pethidine may have advantages over many other epidural opioids. However, potential for accumulation of norpethidine limits its use to relatively short durations of treatment.

[1]  K. Khaw,et al.  Addition of adrenaline to pethidine for epidural analgesia after Caesarean section , 1997, Anaesthesia.

[2]  W. N. Ngan Kee,et al.  Epidural Meperidine After Cesarean Section: The Effect of Diluent Volume , 1997, Anesthesia and analgesia.

[3]  K. Khaw,et al.  Patient-controlled epidural analgesia after Caesarean section using meperidine , 1997, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[4]  T. Gin,et al.  Comparison of Patient-Controlled Epidural Analgesia with Patient-Controlled Intravenous Analgesia Using Pethidine or Fentanyl , 1997, Anaesthesia and intensive care.

[5]  W. N. Ngan Kee,et al.  Postoperative epidural opioid analgesia: what are the choices? , 1997, Anesthesia and analgesia.

[6]  W. N. Ngan Kee,et al.  Patient-controlled epidural analgesia after caesarean section using a disposable device. , 1997, The Australian & New Zealand journal of obstetrics & gynaecology.

[7]  D. E. Roberts,et al.  A comparison of opioid solutions for patient‐controlled epidural analgesia , 1996, Anaesthesia.

[8]  W. N. Ngan Kee,et al.  Epidural Meperidine after Cesarean Section: A Dose‐Response Study , 1996, Anesthesiology.

[9]  D. Williams,et al.  A comparison of epidural infusions of fentanyl or pethidine with bupivacaine in the management of postoperative pain , 1996, Anaesthesia.

[10]  R. Etches,et al.  Patient-Controlled Epidural Analgesia After Thoracotomy: A Comparison of Meperidine With and Without Bupivacaine , 1996, Anesthesia and analgesia.

[11]  T. Gin,et al.  Evaluation of a Disposable Device for Patient-Controlled Epidural Analgesia after Caesarean Section , 1996, Anaesthesia and intensive care.

[12]  S. Evans,et al.  Patient-Controlled Epidural Analgesia following Caesarean Delivery: A Comparison of Pethidine and Fentanyl , 1996, Anaesthesia and intensive care.

[13]  M. Chaney Side effects of intrathecal and epidural opioids , 1995, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[14]  D. Hillman,et al.  Epidural Meperidine Induces Antinociception Without Affecting Urinary Bladder size: A Cystographic Study in Rabbits. , 1995, Regional anesthesia and pain medicine.

[15]  P. Slinger,et al.  Postthoracotomy pulmonary function: a comparison of epidural versus intravenous meperidine infusions. , 1992, Journal of cardiothoracic and vascular anesthesia.

[16]  O. Rosaeg,et al.  Epidural opioid analgesia after Caesarean section: a comparison of patient-controlled analgesia with meperidine and single bolus injection of morphine , 1994, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[17]  R. Miguel,et al.  A Prospective, Randomized, Double‐blind Comparison of Epidural and Intravenous Sufentanil Infusions , 1994, Anesthesiology.

[18]  M. Paech,et al.  Meperidine for Patient‐controlled Analgesia after Cesarean Section Intravenous Versus Epidural Administration , 1994, Anesthesiology.

[19]  M. Anderson,et al.  Paraplegia after continuous subdural meperidine infusion. , 1994, Anesthesiology.

[20]  P. Macintyre,et al.  Norpethidine toxicity and patient controlled analgesia. , 1993, British journal of anaesthesia.

[21]  M. Lawlor,et al.  Epidural Meperidine Provides Surgical Anesthesia for Critically-Ill Patients Undergoing Major Surgery , 1993, Regional Anesthesia & Pain Medicine.

[22]  R. Geller Meperidine in patient-controlled analgesia: a near-fatal mishap. , 1993, Anesthesia and analgesia.

[23]  S. Chrubasik,et al.  The ideal epidural opioid--fact or fantasy? , 1993, European journal of anaesthesiology.

[24]  F. Reynolds Pain relief in labour , 1990, British journal of obstetrics and gynaecology.

[25]  M. R. Jones,et al.  Extradural abscess complicating extradural anaesthesia for caesarean section. , 1992, British journal of anaesthesia.

[26]  G. Handley,et al.  The Addition of Pethidine to Epidural Bupivacaine in Labour — Effect of Changing Bupivacaine Strength , 1992, Anaesthesia and intensive care.

[27]  N. Edwards,et al.  Epidural pethidine and bupivacaine in labour , 1992, Anaesthesia.

[28]  J. Penning,et al.  Patient-controlled Analgesia with Epidural Meperidine after Elective Cesarean Section , 1992, Regional Anesthesia & Pain Medicine.

[29]  J. S. Goldberg,et al.  Use of patient-controlled analgesia to compare the efficacy of epidural to intravenous fentanyl administration. , 1992, Anesthesia and analgesia.

[30]  V. Suderman,et al.  Early respiratory depression during Caesarean section following epidural meperidine , 1992, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[31]  J. Plummer,et al.  An Evaluation of Epidural Bupivacaine with and without Meperidine in Labor , 1991, Regional Anesthesia & Pain Medicine.

[32]  I. Power,et al.  The Effect of Fentanyl, Meperidine and Diamorphine on Nerve Conduction in Vitro , 1991, Regional Anesthesia & Pain Medicine.

[33]  J. Sutherland,et al.  The Influence of Epidural Pethidine on Shivering during Lower Segment Caesarean Section under Epidural Anaesthesia , 1991, Anaesthesia and intensive care.

[34]  R. Sinatra,et al.  Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. , 1990, Anesthesiology.

[35]  I. Wilson,et al.  Analgesia following extradural and i.m. pethidine in post-caesarean section patients. , 1990, British journal of anaesthesia.

[36]  J. Blythe,et al.  Continuous postoperative epidural analgesia for gynecologic oncology patients. , 1990, Gynecologic oncology.

[37]  M. Paech Epidural Pethidine or Fentanyl During Caesarean Section: A Double‐Blind Comparison , 1990, Anaesthesia and intensive care.

[38]  B. Akerman,et al.  Antinociceptive Effects of Localized Administration of Opioids Compared with Lidocaine , 1989, Regional Anesthesia & Pain Medicine.

[39]  A. Sandler,et al.  Respiratory depression and spinal opioids , 1989, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[40]  R. McKay,et al.  Epidural Bupivacaine-Pethidine Mixture: Clinical Experience Using a Low-dose Combination in Labour , 1989 .

[41]  J. Hsieh,et al.  Epidural meperidine: a novel approach to anesthetic management for extracorporeal shock wave lithotripsy--a comparison with epidural marcaine. , 1988, Ma zui xue za zhi = Anaesthesiologica Sinica.

[42]  P. Hartvig,et al.  Pharmacokinetics of Epidural Morphine and Meperidine in Humans , 1987, Anesthesiology.

[43]  J. Plummer,et al.  The influence of drug polarity on the absorption of opioid drugs into CSF and subsequent cephalad migration following lumbar epidural administration: application to morphine and pethidine , 1987, Pain.

[44]  I. Acalovschi Herpes simplex after spinal pethidine , 1986, Anaesthesia.

[45]  A. Casy,et al.  Pethidine and Related 4-Phenylpiperidine Analgesics , 1986 .

[46]  R. Robinson,et al.  Hypertension after epidural meperidine , 1985, Canadian Anaesthetists' Society journal.

[47]  D. Frewin,et al.  A Comparative Study of Techniques of Postoperative Analgesia following Caesarean Section and Lower Abdominal Surgery , 1985 .

[48]  L. Mather,et al.  Intrathecal and epidural administration of opioids. , 1984, Anesthesiology.

[49]  L. Mather Clinical Pharmacokinetics of Fentanyl and its Newer Derivatives , 1983, Clinical pharmacokinetics.

[50]  P. Brownridge,et al.  Respiratory Depression following Accidental Subarachnoid Pethidine , 1983, Anaesthesia and intensive care.

[51]  K. Payne Epidural versus intramuscular pethidine in postoperative pain relief. , 1983, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[52]  P. Brownridge Epidural and intrathecal opiates for postoperative pain relief , 1983, Anaesthesia.

[53]  L. Mather,et al.  Peridural Meperidine in Humans: Analgetic Response, Pharmacokinetics, and Transmission into CSF , 1982 .

[54]  D. A. Pybus,et al.  Comparison of four narcotic analgesics for extradural analgesia. , 1982, British journal of anaesthesia.

[55]  J. Stonham,et al.  Comparison of epidural and intramuscular pethidine for analgesia in labour. , 1981, British journal of obstetrics and gynaecology.

[56]  P. Brownridge Epidural pethidine. , 1981, Anaesthesia and Intensive Care.

[57]  K. Austin,et al.  Relationship Between Blood Meperidine Concentrations and Analgesic Response: A Preliminary Report , 1980, Anesthesiology.

[58]  B. Perriss Epidural pethidine in labour , 1980, Anaesthesia.

[59]  F. Magora,et al.  EPIDURAL MORPHINE IN TREATMENT OF PAIN , 1979, The Lancet.

[60]  L. Mather,et al.  Selective spinal analgesia. , 1979, Lancet.

[61]  P. Wiener,et al.  Neonatal respiration, feeding and neurobehavioural state. Effects of intrapartum bupivacaine, pethidine and pethidine reversed by naloxone. , 1979, Anaesthesia.

[62]  H. Szeto,et al.  Accumulation of normeperidine, an active metabolite of meperidine, in patients with renal failure of cancer. , 1977, Annals of internal medicine.

[63]  W. S. Koski,et al.  Microelectrometric titration measurement of the pKa's and partition and drug distribution coefficients of narcotics and narcotic antagonists and their pH and temperature dependence. , 1975, Journal of medicinal chemistry.

[64]  W. Nimmo,et al.  NARCOTIC ANALGESICS AND DELAYED GASTRIC EMPTYING DURING LABOUR , 1975, The Lancet.

[65]  E. Way Studies on the local anesthetic properties of isonipecaine. , 1946, Journal of the American Pharmaceutical Association. American Pharmaceutical Association.

[66]  O. Schaumann,et al.  Dolantin, ein neuartiges Spasmolytikum und Analgetikum , 1939 .