A Pharmacokinetic Approach to Postoperative Pain: Continuous Infusion of Pethidine

Stapleton, J.V.; Austin, K. L.; Le, Mather

doi:10.1177/0310057x7900700103

Cited by 87 publications

(24 citation statements)

References 18 publications

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“…Data were obtained during a study of the efficacy of continuous narcotic administration in the management of post-surgical pain in ten female patients undergoing abdominal hysterectomy (Stapleton, Austin & Mather, 1979). Physical characteristics of the patients are given in Table 1, but other patient and clinical management details are given in the original reference.…”

Section: Patients and Patient Managementmentioning

confidence: 99%

Pethidine clearance during continuous intravenous infusions in postoperative patients.

Austin¹,

Stapleton²,

Mather³

1981

Brit J Clinical Pharma

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1 Pethidine pharmacokinetics in ten female patients during continuous i.v. infusion for 32 h post‐surgery have been determined. 2 The blood clearance of pethidine (mean +/− 2.d.) measured directly was 599 +/− 135 ml/min and is in marked contrast to some reported values. 3 Other model‐dependent pharmacokinetic parameters were consistent with previously reported values. 4 Pethidine and indocyanine green clearance were correlated but the correlation was mediated through body weight. 5 Pethidine clearance and steady state concentration were predictable retrospectively from linear multivariable equations involving simple physical characteristics of the patient.

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Section: Patients and Patient Managementmentioning

confidence: 99%

Pethidine clearance during continuous intravenous infusions in postoperative patients.

Austin¹,

Stapleton²,

Mather³

1981

Brit J Clinical Pharma

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“…It has been suggested, however, that the intravenous route offers defmite advantages, such as a rapid onset of analgesia and greater flexibility in adjustment to changing needs (Forrest, 1968;Mather and Meffin, 1978;Masson, 1967Masson, , 1971Pflug and Bonica, 1977). For postoperative pain relief, Stapleton et al (1979) designed an intravenous infusion regimen for pethidine (meperidine) which comprised a loading infusion followed by a standardised constant infusion of 24mg/hour. For postoperative pain relief, Stapleton et al (1979) designed an intravenous infusion regimen for pethidine (meperidine) which comprised a loading infusion followed by a standardised constant infusion of 24mg/hour.…”

mentioning

confidence: 99%

Patient-controlled Analgesic Therapy, Part II

Tamsen

Hartvig

Fagerlund

et al. 1982

Clinical Pharmacokinetics

117

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20 survival patients were allowed to self-administer small intravenous doses of pethidine to relieve pain after major abdominal surgery. Pethidine injections were given by means of a programmable drug injector. Pethidine consumption varied from 12 to 50mg/h with a mean +/- SD of 26 +/- 10mg/h. The mean measured plasma concentration of pethidine during self-administration was 551 +/- 182 ng/ml, with a range of 132 to 896 ng/ml. Minimum effective concentrations averaged 455 +/- 174 ng/ml. Individual pethidine consumption and mean plasma concentrations did not differ between men and women, and were not correlated to variations in age, anthropometric factors, plasma clearance or elimination rate constant for pethidine. Individual consumption of pethidine was consistent, with stable plasma concentrations throughout most of the trial period. Pseudo-steady-state plasma concentrations of pethidine were established and maintained at widely different levels. 19 of the 20 patients obtained subjectively satisfactory analgesia.

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“…Stepleton et al . [17] assessed another regimen for the intravenous infusion of pethidine. They gave a loading dose of 1 mg/min for 45 min followed by 0.53 mg/min for 28 min.…”

Section: Discussionmentioning

confidence: 99%

Observational study to assess the effectiveness of postoperative pain management of patients undergoing elective cesarean section

Ismail

Shahzad

Shafiq

2012

J Anaesthesiol Clin Pharmacol

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Background:The study was designed to assess the strategy, effectiveness, and safety of postoperative pain management in patients undergoing elective cesarean section in the obstetric unit of our hospital.Materials and Methods:Patients having elective cesarean section from December 2008 to May 2009 were included in this observational study. We recorded patient's demographics, postoperative pain orders, and analgesia regime on the day of surgery. Anesthesia team, which included one of the investigators, assessed the overall pain since the time of surgery by visual analogue scale (VAS) and also recorded any complications since the time of surgery and patients’ satisfaction with the pain management.Results:A total of 263 patients were reviewed during the study period. Postoperative analgesia regime was started by the obstetric team in 81% of patients and in rest by the anesthesia team. The common modality of pain management was intravenous opioid infusion (94%) and coanalgesia was used in 99% of patients. The analysis of pain at rest by VAS was between 1 and 3 in 89.7%, 4 and 6 in 9.5%, and 7 and 10 in 0.8% of patients. The VAS on movement was 1–3 in 60.1%, 4–6 in 33.1%, and 7–10 in 6.8% of patients. Patients’ opinion regarding postoperative pain management was satisfactory in 91.6% of patients and unsatisfactory in 8.4% of patients. Overall, 9% of patients had minor complications, which responded well to treatment.Conclusion:The regime for postoperative pain management was mostly started and followed by the obstetric team at the hospital. Although the postoperative pain management was adequate in terms of patients’ safety, it was not effective according to the goal set by Joint Commission on Accreditation of uniformly low pain score of not more than 3 out of 10 both at rest and with movement.

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A Pharmacokinetic Approach to Postoperative Pain: Continuous Infusion of Pethidine

Cited by 87 publications

References 18 publications

Pethidine clearance during continuous intravenous infusions in postoperative patients.

Pethidine clearance during continuous intravenous infusions in postoperative patients.

Patient-controlled Analgesic Therapy, Part II

Observational study to assess the effectiveness of postoperative pain management of patients undergoing elective cesarean section

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