Continuous infusion of meptazinol and pethidine in the relief of post-operative pain.
Thirty patients who had undergone major abdominal surgery were randomly assigned to a continuous infusion of either 0.45 mg meptazinol/kg/hr or 0.3 mg pethidine/kg/hr. Analgesia was assessed by rating scale, ranging from 0 (no pain) to 10 (unbearable pain), and by questionnaire. Respiration rate was closely monitored and end-tidal PCO2 measured. Both drugs provided effective analgesia. The median rating of pain over the 24 hr post operation was 2.6 with meptazinol and 2.9 with pethidine, a difference that was not statistically significant. No patient in either group reported a distressing degree of discomfort. Although no patients exhibited clinically significant respiratory depression or sleep apnoea, high (greater than 6 Kpa) end-tidal PCO2 values were significantly more frequent in the pethidine than in the meptazinol group (P less than 0.01). This suggests a greater margin of safety with the use of meptazinol. The smaller effect of meptazinol on respiratory activity might make it especially appropriate for administration by continuous infusion--a technique which has practical advantages over intermittent intramuscular injection and which has been shown to be more effective in the control of post-operative pain. Patients' responses in the present study demonstrate the efficacy of continuous infusion as a means of relieving post-operative pain and confirm previous findings that 0.5 mg/kg/hr meptazinol provides a good degree of analgesia.
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000375:Aging; D001381:Azepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008614:Meperidine / Q000009:adverse effects / Q000627:therapeutic use*; D008621:Meptazinol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D012119:Respiration / Q000187:drug effects; D012737:Sex Factors; D013997:Time Factors
D001381:Azepines; D008621:Meptazinol; D008614:Meperidine