title: Does meperidine analgesia affect the incidence of obstetric lacerations at vaginal delivery?
abstract: OBJECTIVE
  To study whether meperidine analgesia affects the incidence of obstetric lacerations at normal vaginal deliveries.
  
  
  METHODS
  A retrospective cohort study of all women with term vertex singleton pregnancies, who underwent normal vaginal deliveries, in a single tertiary hospital, between 2011 and 2015, was performed. The incidence of various obstetric lacerations was compared between deliveries with meperidine analgesia and deliveries with no analgesia. Deliveries with epidural analgesia and instrumental deliveries were excluded. An intravenous infusion of 75 mg of meperidine was administered together with 25 mg of promethazine. A multivariate logistic regression analysis was performed to assess the association between meperidine analgesia and obstetric lacerations, after controlling for confounders.
  
  
  RESULTS
  Overall, 5227 (91.8%) deliveries with no analgesia and 466 (8.1%) deliveries with meperidine analgesia were included. Meperidine analgesia was associated with a decreased risk of first- and second-degree perineal lacerations (adjusted OR = 0.63, 95% CI = 0.49-0.81), and a decreased risk of any suturing (adjusted OR = 0.73, 95% CI = 0.59-0.91), after controlling for confounders. Meperidine analgesia did not affect the risk of severe perineal lacerations or episiotomies.
  
  
  CONCLUSIONS
  Meperidine analgesia may have a protective effect against first- and second-degree perineal lacerations.
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Yossi
authors.identifier: http://orcid.org/0000-0002-2533-6972
authors.initials: Y
authors.lastname: Mizrachi
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Sophia
authors.initials: S
authors.lastname: Leytes
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Levy
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Shimon
authors.initials: S
authors.lastname: Ginath
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|c Department of Anesthesia , Edith Wolfson Medical Center , Holon , Israel.|d Outcomes Research Consortium , Cleveland , OH , USA.
authors.forename: Tiberiu
authors.initials: T
authors.lastname: Ezri
authors.affiliation: a Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv-Yafo , Israel.|b Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Kovo
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008614:Meperidine / Q000627:therapeutic use*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine
keywords: Meperidine; OASIS; analgesia; perineal lacerations