Epidural meperidine for control of autonomic hyperreflexia in a quadriplegic undergoing cystoscopy.
Epidural meperidine was used to control autonomic hyperreflexia (AH) during cystoscopy and transuretheral sphincterotomy, in a quadriplegic patient who had chronic spinal cord transection at C6 level. Meperidine 100 mg diluted in 10 ml saline was injected in the epidural space at L3-L4 level. Within 10 minutes and throughout the surgical procedure, the blood pressure stabilized at 125/70-140/80 mmHg. Epidural meperidine produces selective blockade of the spinal opiate receptors and hence may block the nociceptive reflexes below the level of cord transection and prevent AH.
Baraka
A
A
Department of Anesthesiology, American University, Beirut, Lebanon.
Noueihid
R
R
Sibai
A N
AN
Baroody
M
M
Louis
F
F
Hemady
K
K
D001342:Autonomic Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D003558:Cystoscopy; D006801:Humans; D007268:Injections, Epidural; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011782:Quadriplegia / Q000150:complications*; D012021:Reflex, Abnormal / Q000187:drug effects*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery; D014555:Urination Disorders / Q000209:etiology / Q000601:surgery
D008614:Meperidine