Meperidine in Patient-Controlled Analgesia

Estimation of infant dose and exposure to pethidine and norpethidine via breast milk following patient-controlled epidural pethidine for analgesia post caesarean delivery

“…7,8 Plasma concentrations of both pethidine and norpethidine in both neonates and their mothers in our study were well below the toxic levels of 2346 lg/L and 1856 lg/ L for pethidine and norpethidine, respectively, for adults. 5,34 Pethidine concentrations in both plasma and milk at the second sampling time were significantly lower than at the first, which reflects the cessation of maternal use of pethidine in the interim. Mean plasma pethidine concentrations (326 lg/L and 114 lg/L at sampling times 1 and 2, respectively) were below the mean minimum effective analgesic concentration in plasma for severe postoperative pain (450 lg/L) after parenteral administration, except in patients 3 (531 lg/L), 5 (507 lg/L) and 17 (537 lg/L) at the first sampling time.…”

Morphine overdose from error propagation on an acute pain service

“…[6][7][8] Numerous reports of safety hazards and deaths associated with PCA pumps have been reported in the literature since the introduction of this technology. 4,5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] The following report is a case of respiratory arrest associated with PCA morphine, and illustrates the multiple levels at which errors can occur with PCA administration. Consent was obtained from the patient for use of personal health information in this case report in accordance with our institutional guidelines.…”

Death during patient-controlled analgesia: piritramide overdose and tissue distribution of the drug

“…antibiotics) due to a temporarily blocked i.v. catheter [43,44] Cracked syringe barrel [45] Anaphylaxis Extraordinary sensitivity to opiates (in elderly), renal failure, preexisting sleep apnea syndrome, background infusion or concomitant administration of sedative/hypnotic medications resulting in unexpected respiratory depression [10,11,46] Reprogramming with criminal intent 1.5 mg/h. According to the patient's record, the cartridge was changed at 11:50 p.m.; here, the patient was found still awake and free of pain, he reported to be satisfied with PCA and did not show any symptoms and signs of a potential piritramide overdosage.…”