Decreased use of petidine in a private hospital with the implementation of a multiprofessional educative program

Minson, Fabíola Peixoto; Júnior, Jamir Sardá; Ferracini, Fabio Teixera; Lopes, Ana Carolina Biagioni; Júnior, Constantino José Fernandes

doi:10.1590/s1806-00132011000100008

Cited by 4 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The International Association for the Study of Pain (IASP), the WHO and other entities recommend restricted use of meperidine to manage acute pain and its replacement, whenever possible, by other less toxic opioids; and strongly condemn its use to manage chronic pain, which in addition to toxicity may also induce chemical dependence because the development of tolerance to meperidine is very fast and may appear even with a single dose 1,7 . However, this restriction or replacement seems not to be occurring because available studies report excessive meperidine consumption in Brazilian and other developing countries hospitals 3 . A study 13 has observed meperidine and morphine prescription profile in a hospital and has concluded that the most frequently used opioid was meperidine, being present in 90% of evaluated prescriptions, especially to manage postoperative pain.…”

Section: Contentsmentioning

confidence: 99%

“…The percentage of meperidine prescription as compared to the prescription of other opioids during hospital stay is used as hospital quality standard and accreditation in developed countries, being accepted up to 20% of meperidine prescription among total opioids in emergency settings, and up to 10% for hospitalization sectors, being that in institutions where these percentages are exceeded, physicians receive therapeutic update courses with emphasis meperidine 7 . The implementation of the educational multidisciplinary protocol to decrease meperidine prescription in the Israelite Hospital Albert Einstein was effective because it has significantly contributed to decrease its consumption 3 . In 2006, the Ministry of Health has recommended the exclusion of meperidine from the National List of Essential Drugs (RENAME) due to the presence of the neurotoxic metabolite normeperidine, its short action time and for being three times more expensive than morphine without having therapeutic advantages 25 .…”

Section: Contentsmentioning

confidence: 99%

“…Pain evaluation is critical for its adequate control, since several studies have shown that non-relieved pain limits individuals in their daily activities, changes mood, exacerbates pain fear, thus affecting the quality of life (QL) of patients and their caregivers 2 . The World Health Organization (WHO) recommends strong opioids to manage acute or severe chronic pain, associated or not to non-opioids, adjuvants or non-pharmacological techniques, aiming at improving pain and QL 1, 3 . Meperidine is a strong opioid, however due to some unique features WHO itself and the authors of national and international articles or governmental publications published between 1997 and 2013 and searched in this study, report the non-recommendation of its use for analgesia and suggest its replacement by other opioids.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Meperidine: opioid not indicated for analgesia

Botan¹,

Lapena²

2015

Revista Dor

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Pain evaluation and the choice of the analgesic best providing its control are extremely important for patients' quality of life. This study aimed at describing the characteristics which make meperidine unfeasible for pain management, at calling the attention to the incidence of its prescriptions and to the need of a multidisciplinary educative action aiming at decreasing its use, in addition to presenting two opioids as options for analgesia. CONTENTS: National or international scientific and governmental publications between the years 1997 and 2013 used in this study report that meperidine is not indicated for pain management, primarily due to its short action time, presence of neurotoxic metabolite (normeperidine) and possibility of rapidly developing tolerance. CONCLUSION: According to analyzed data, meperidine was the most widely used opioid for analgesic or was among the most prescribed analgesics. This fact shows the real need for an educative multidisciplinary action to promote awareness of meperidine risks and to decrease its prescription. According to searched literature, morphine and methadone have longer action time and higher analgesic potency, with metabolites which are less toxic and noxious for patients as compared to meperidine.

show abstract

Section: Contentsmentioning

confidence: 99%

Section: Contentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Meperidine: opioid not indicated for analgesia

Botan¹,

Lapena²

2015

Revista Dor

View full text Add to dashboard Cite

show abstract

Is Pethidine Safe during Labor? Systematic Review

Nunes

Colares

Montenegro

2017

Rev Bras Ginecol Obstet

View full text Add to dashboard Cite

Purpose To verify if pethidine is safe for the conceptus when used during labor. Methods Systematic review in the Capes Periodicals/PubMed and MEDLINE/Virtual Health Library (BVS, in the Portuguese acronym) databases. Results A total of 17 studies published from January 1st, 2000, to September 2nd, 2016, with a total of 1,688 participants involved were included in the present review. There was no record of conceptus vitality decrease associated with low doses of pethidine being administered to mothers during labor. Conclusions Intramuscular (IM) or intravenous (IV) pethidine at low doses, of up to 50 mg, is safe to administer during labor.

show abstract

Opioid use, regulation, and harms in Brazil: a comprehensive narrative overview of available data and indicators

Maia

Daldegan‐Bueno

Fischer

2021

Subst Abuse Treat Prev Policy

View full text Add to dashboard Cite

Background Global opioid consumption increased multifold post-2000, disproportionately in high-income countries, with severe mortality/morbidity consequences. Latin America features comparatively low opioid availability; Brazil, the region’s most populous country, makes an interesting case study concerning opioid use/harms. In this comprehensive overview, we aimed to identify and summarize medical and non-medical data and indicators of opioid availability and use, regulation/control, and harm outcomes in Brazil since 2000. Methods We searched multiple scientific databases to identify relevant publications and conducted additional ‘grey’ literature searches to identify other pertinent information. Results Despite some essential indicators, opioid-related data are limited for Brazil. Data indicate that population-level availability of prescription opioids represents only a small fraction of use in comparison to high-income countries. However, within Latin America, Brazil ranks mid-level for opioid consumption, indicating relatively moderate consumption compared to neighboring jurisdictions. Brazil has implemented restrictive regulations to opioid prescribing and is considered ‘highly restricted’ for opioid access. Codeine remains the major opioid analgesic utilized, but stronger opioids such as oxycodone are becoming more common. Professional knowledge regarding medical opioid use and effects appears limited. National surveys indicate increases in non-medical use of prescription opioids, albeit lower than observed in North America, while illicit opioids (e.g., heroin) are highly uncommon. Conclusions Overall population-level opioid availability and corresponding levels of opioid-related harms in Brazil remain substantially lower than rates reported for North America. However, the available surveillance and analytical data on opioid use, policy/practice, and harms in Brazil are limited and insufficient. Since existing and acute (e.g., pain-related) needs for improved opioid utilization and practice appear to be substantiated, improved indicators for and understanding of opioid use, practice, and harms in Brazil are required.

show abstract

Decreased use of petidine in a private hospital with the implementation of a multiprofessional educative program

Cited by 4 publications

References 11 publications

Meperidine: opioid not indicated for analgesia

Meperidine: opioid not indicated for analgesia

Is Pethidine Safe during Labor? Systematic Review

Opioid use, regulation, and harms in Brazil: a comprehensive narrative overview of available data and indicators

Contact Info

Product

Resources

About