Background: Meperidine, a synthetic opioid, has a rapid onset and short duration of action.
Mounting evidence has challenged meperidine’s analgesic benefits, and concerns have been raised
about its safety profile. Despite recommendations to restrict the prescription of meperidine, the
drug remains frequently used.
Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety
of meperidine for acute postoperative and labor pain.
Study Design: This was a narrative review of the analgesic efficacy and side effects of meperidine
compared to other analgesic drugs for acute postoperative and labor pain in adults.
Setting: Randomized controlled trials that compared the analgesic efficacy and side effect profile
of meperidine versus another analgesic drug in adult patients were evaluated.
Methods: A systemized search of randomized controlled trials studying meperidine for acute
postoperative or labor pain in the adult patient population from PubMed, Medline, and EMBASE was
performed. Included studies reported on different routes of meperidine administration including
intramuscular, intravenous, and patient-controlled analgesia in various surgical procedures such
as abdominal surgery, Cesarean section, gynecological surgery, orthopedic surgery, cardiothoracic
surgery, as well as for labor analgesia. Meperidine’s analgesic efficacy and safety profile were
compared to other opioids (morphine, tramadol, fentanyl, buprenorphine, nalbuphine, and
pentazocine), nonsteroidal anti-inflammatory drugs (ketorolac, diclofenac, and indomethacin),
dipyrone, ketamine, and bupivacaine.
Results: A total of 62 randomized controlled trials published between 1972 and 2018 were
reviewed. Meperidine had a similar or inferior analgesic efficacy compared to other analgesics for
acute postoperative or labor pain. Meperidine was associated with more sedation and respiratory
depression.
Limitations: The sample sizes of many clinical studies were small, and therefore probably
insufficiently powered to detect differences in uncommon side effects, such as central nervous
system toxicity. In addition, some of the included clinical studies were old.
Conclusion: Considering the availability of other effective analgesics with potentially fewer side
effects, the use of meperidine for acute postoperative or labor pain should not be recommended.
Key words: Acute postoperative pain, adverse effects, labor analgesia, meperidine, pethidine
COMPARATIVE EFFICACY AND SAFETY OF RIVAROXABAN-BASED DUAL-PATHWAY ANTITHROMBOTIC THERAPY VERSUS DUAL ANTIPLATELET THERAPY: A POOLED ANALYSIS OF CONTEMPORARY RANDOMIZED CONTROLLED TRIALS
