The effect of meperidine on the peripheral circulation

Abstract

While morphine and its derivatives have long been used for the relief of pulmonary edema, the mode of action has not yet been completely clarified. Experimentally produced pulmonary edema in dogs can be prevented by hypnotics, morphine, and meperidine ( Demerol), but the mechanism of their action is not well understood either.The interpretation of animal experiments on the circulatory effects of narcotics is difficult because of species differences. Experiments on patients with acute pulmonary edema are rarely feasible. We were unable to find any information on the effect of meperidine on the peripheral circulation of man. This study is therefore concerned with the investigation of the effect of meperidine on the peripheral circulation of man. It has been suggested, on the basis of animal experiments, that morphine relieves pulmo-

The Cardiovascular Effects of Morphine THE PERIPHERAL CAPACITANCE AND RESISTANCE VESSELS IN HUMAN SUBJECTS

“…The possibility of activation of sympathetic cholinergic fibers was also ruled out by the demonstration that intraarterial atropine did not inhibit the effects of intravenous morphine to dilate the forearm resistance vessels (Fig 10C and D). This is consistent with the findings of Nadasdi and Zsoter, who showed that the forearm arteriolar dilation induced by meperidine is not attenuated by atropine (50). The lack of effect of propranolol blockade would also speak against a significant beta adrenergic effect from adrenal epinephrine.…”

“…It is known that morphine, when given to a number of species, will release histamine from skeletal muscle (45)(46)(47)(48)(49)(50)(51)(52). Humans seem to release less histamine than dogs.…”

The Hemodynamic Effects of Intravenous Bolus Doses of Meperidine in Conscious Sheep

“…Apart from the effects of increased CO (in 200-and 300-mg dose groups), any specific mechanism of this effect is not clear. Meperidine can reduce peripheral vascular resistance and increase blood flow in human limbs (32), and it has been shown in nitro to induce constriction of the circular muscle of bovine coronary arteries (33). The fact that coronary blood flow was increased in the presence of increased LVEDP, and without significant changes of MAP in the first 0.5 min after the injections, suggests a direct effect of meperidine on the coronary circulation.…”

Pharmacological and clinical importance of narcotic antagonists and mixed antagonists‐use in cardiology.

“…Nadasdi & Zsoter (1969) gave pethidine 1 mg/kg intravenously to 46 volunteers, six of whom had cardiac failure, and found that pethidine significantly increased blood flow in the forearm and leg with a concomitant fall in arterial and venous resistance. This is evidence that pethidine acts, like morphine, by promoting peripheral pooling of blood.…”