Meperidine (pethidine) versus morphine in acute pain management of opioid-dependent patients

Abstract

The present study aimed to evaluate the effectiveness of morphine and meperidine (pethidine) as pain relief in opioid-dependent patients with acute pain. A total of 122 opioid-dependent patients with acute pain were included in the study. Their pain severity was assessed, using visual analog scale (VAS) scores ranging from 0 to 10. The patients randomly received intravenous morphine (up to 0.15 mg/kg) or meperidine (up to 1.5 mg/kg) for pain control by patient control analgesia (PCA) pump. The clinical opioid withdrawal scale (COWS) was employed for the assessment of withdrawal symptoms. The pain relief and the emergence of withdrawal symptoms were measured at 15, 30, and 60 minutes after drug administration. The patients who received morphine reported a better pain control compared to those who received meperidine (mean ± standard deviation [SD] VAS scores 4.11±1.90 vs 5.85±2.08 at the end of the study; P<0.001). On the other hand, the patients who received meperidine indicated prominent withdrawal symptoms (mean ± SD COWS scores 4.80±2.18 vs. 1.98±0.82 at the end of the study; P<0.001). Our findings revealed that morphine can be recommended in acute pain management of opioid-dependent patients. In addition, emergency physicians should ask their patients about any drug dependence before selecting the appropriate drug for their acute pain management.

Synchronized extracorporeal shockwave lithotripsy may still affect the heart: a case report of perioperative ST-segment elevation myocardial infarction

“…Some studies have demonstrated similar pain relief efficacy in patients with MI between the pethidine and morphine groups. However, Solhi et al reported poor pain control in the pethidine group ( 11 ). Even though pethidine is not a recommended MI drug, it may help diagnose difficulties due to analgesia.…”

Pethidine dependence syndrome in a patient with stump pain

“…Wobec tego zdecydowano o konieczności odstawienia petydyny i zastosowania morfiny w postaci podskórnej w zaostrzeniach bólu, zwłaszcza że Solhi i wsp. w badaniu z udziałem 122 osób uzależnionych od opioidów wykazali istotnie lepszą skuteczność leczenia przeciwbólowego po zastosowaniu morfiny względem petydyny [38]. Postępowanie takie okazało się skuteczne; po rotacji petydyny na morfinę w zaostrzeniach bólu obserwowano znaczną redukcję liczby stosowanych doraźnie dawek leku.…”