Understanding Anesthesiology - The Global Regional Anesthesia ...

MEPERIDINE
Class
Opioid analgesic (long acting). Traditionally used for
postoperative pain but currently its use is restricted (in
many hospitals) to the treatment of postoperative shivering.
Mechanism of Action
Acts at the mu and kappa opioid receptors.
Dose
In adults: 25-75 mg IV/IM (0.5-2 mg/kg)
Onset
IV: 3-8 minutes
IM: 10-20 minutes
Effects
CNS
Causes dose-related sedation; variable analgesic effect.
Delirium in older patients is often seen. May cause seizures
if used in large doses or over an extended time
frame due to the accumulation of its excitatory metabolite,
normeperidine. May cause euphoria and dysphoria.
All of the depressant effects of meperidine are potentiated
by concurrent use of sedatives, volatile anesthetics,
nitrous oxide and tricyclic antidepressants.
Respiratory
Respiratory depression which at the extreme leads to apnea.
May promote bronchospasm in susceptible patients
(those with asthma or COPD).
GI
Nausea, vomiting, biliary tract spasm, constipation.
Misc.
Effective in the treatment of postoperative shivering.
May cause muscle rigidity, urticaria, pruritis.
Contraindications:
Meperidine must not be used in patients on monoamine
oxidase inhibitors in whom it can cause a fatal reaction.
Duration
2-4 hours IV/IM
Elimination
Hepatic
109