title: The peripheral analgesic effect of meperidine in reducing propofol injection pain is not naloxone-reversible.
abstract: OBJECTIVE
  Meperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propofol injection pain than fentanyl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic effect of meperidine is affected by naloxone.
  
  
  METHODS
  In a randomized, double-blind manner, after venous occlusion with a tourniquet, meperidine 40 mg was given intravenously to patients in group A (n = 31), meperidine 40 mg followed by naloxone 0.04 mg to group B (n = 32), meperidine 40 mg followed by naloxone 0.2 mg to group C (n = 30), and normal saline placebo to group D (n = 30). The venous retention of drug(s) was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol 100 mg. Pain assessment was made immediately after the propofol injection.
  
  
  RESULTS
  All three groups given meperidine had significantly less propofol injection pain (P < .01 ) than the group given saline placebo, and there was no difference among groups A, B, and C.
  
  
  CONCLUSIONS
  The peripheral analgesic effect of meperidine in reducing propofol injection pain is not mediated by its opioid activity.
authors.affiliation: Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, Republic of China.
authors.forename: W W
authors.initials: WW
authors.lastname: Pang
authors.forename: M S
authors.initials: MS
authors.lastname: Mok
authors.forename: S
authors.initials: S
authors.lastname: Huang
authors.forename: Y T
authors.initials: YT
authors.lastname: Chung
authors.forename: M H
authors.initials: MH
authors.lastname: Hwang
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage* / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000097:blood; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects*; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000097:blood; D008875:Middle Aged; D009270:Naloxone / Q000494:pharmacology*; D009292:Narcotic Antagonists / Q000494:pharmacology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement / Q000187:drug effects; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects*; D014111:Tourniquets
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D009292:Narcotic Antagonists; D009270:Naloxone; D008614:Meperidine; D015742:Propofol