Advanced concepts and controversies in emergency department pain management. Anesthesiol Clin. Acute pain management: scientific evidence. Accessed Feb Single dose ketorolac and pethidine in acute post-operative pain: systemic review with meta-analysis.
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Textbook of anesthesia. Spain: Churchill Livingstone; Tarkkila P, Saarnivaara L. Ketoprofen, diclofenac or ketorolac for pain after tonsillectomy in adults. James D, Justins D. Acute post-operative pain. India: Arnold; Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Dalia M. Dalia M. Amin and Ahmed M. El Teliti declare no conflict of interests in relation to this article. Reprints and Permissions.
Amin, D. Pethidine versus morphine in postoperative pain relief of opioid-dependent patients in Zagazig University Hospital, Asharqia, Egypt. Drugs Ther Perspect 34, — Download citation. Published : 07 August Issue Date : October Anyone you share the following link with will be able to read this content:.
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Search SpringerLink Search. Abstract Background Postoperative pain management is a challenge in opioid-dependent patients as this patient group is often undertreated for pain. Objectives The aim of this study was to evaluate the analgesic and adverse effects of pethidine versus morphine in postoperative pain relief in opioid-dependent patients after major surgery.
Methods Eighty opioid-dependent patients undergoing major surgical operations were included in our study. Results Pethidine and morphine had similar analgesic effects at 6 and 12 h postoperatively, but morphine had better analgesic effects at 24 and 48 h. Conclusion Morphine is a more effective and better tolerated analgesic than pethidine in the management of postoperative pain in opioid-dependent patients. References 1. Article Google Scholar 3. Article Google Scholar 4.
Google Scholar 5. Article Google Scholar 6. Article Google Scholar 7. Article Google Scholar 8. Google Scholar 9. Article Google Scholar Google Scholar Google Scholar Download references. El Teliti Authors Dalia M. Amin View author publications. View author publications. Ethics declarations Conflict of Interest Dalia M. Opioids have been utilized for thousands of years to treat pain and still continue to be one of the most commonly prescribed medications for acute pain management in the ED.
There are few studies that have compared the analgesic effects of meperidine and morphine in non-opioid-dependent patients. The present study was designed to clarify this issue. Of the to year-old opioid-dependent patients who presented to the ED of Hazrat Valiasr Hospital in Arak, Iran for acute pain control between March 20, and September 21, , patients were randomly selected. These patients were dependent on methadone, heroin, opium, opium dross, or refined opium dross Shireh.
In case of suspected acute abdomen, hypotension, head trauma, liver diseases, decreased renal function, and earlier administration of any drugs for pain relief prior to the ED presentation, the patients were excluded from our study. Pain severity was assessed, using visual analog scale VAS scores ranging from 0 to Pain relief and emergence of withdrawal symptoms were assessed at 15, 30, and 60 minutes after drug administration. The clinical opioid withdrawal scale COWS was employed for the evaluation of withdrawal symptoms in the patients.
The study was approved by the local ethical committee of Arak University of Medical Sciences. All of the patients provided written consent forms. The results were analyzed by SPSS software version A total of patients were assigned into two patient groups.
The mean VAS scores of the groups are demonstrated in Table 1. The severity of withdrawal symptoms during the study is illustrated in Table 2. In addition to methadone that is orally used in methadone maintenance treatment programs and heroin that is intravenously or inhalationally abused, opium, opium dross, and refined opium dross Shireh are the opioids commonly abused in Iran orally or inhalationally.
The filtrate is evaporated until a gummy consistency is achieved. It has been stated that acute pain management is a challenge in opioid-dependent patients since they are often undertreated for pain. Therefore, in acute pain management in these patients, an appropriate opioid with an appropriate dosage should be given to them to control the pain and prevent the development of withdrawal symptoms.
The present study compared the effectiveness of morphine and meperidine in the management of acute pain as well as the development of withdrawal symptoms in the patients. The results confirmed that meperidine was less effective in acute pain management compared to morphine.
To date, a number of studies have been performed that have compared the analgesic effects of meperidine and morphine via PCA in non-opioid-dependent patients, indicating that meperidine can only control mild pain in comparison with morphine. It was also revealed that patients who received meperidine experienced more withdrawal, while meperidine is a pure agonist and should not cause withdrawal per se.
According to our findings, we recommend using morphine, rather than meperidine, in acute pain management of opioid-dependent patients. Emergency physicians should query their patients about any drug dependence before selecting the appropriate drug for their acute pain management. National Center for Biotechnology Information , U. Open Access Emerg Med. Published online Aug Author information Copyright and License information Disclaimer. This work is published and licensed by Dove Medical Press Limited.
By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Abstract The present study aimed to evaluate the effectiveness of morphine and meperidine pethidine as pain relief in opioid-dependent patients with acute pain. Keywords: pain management, meperidine, morphine, opioid dependency, withdrawal symptoms.
Introduction Pain is a major medical problem. Materials and methods Of the to year-old opioid-dependent patients who presented to the ED of Hazrat Valiasr Hospital in Arak, Iran for acute pain control between March 20, and September 21, , patients were randomly selected.
Results A total of patients were assigned into two patient groups. Assessment time Morphine group Meperidine group P -value Start of the study 7. Open in a separate window. Abbreviation: SD, standard deviation.
Assessment time Morphine group Meperidine group P-value Start of the study none none — 15 minutes after drug therapy 1. Discussion In addition to methadone that is orally used in methadone maintenance treatment programs and heroin that is intravenously or inhalationally abused, opium, opium dross, and refined opium dross Shireh are the opioids commonly abused in Iran orally or inhalationally.
Footnotes Disclosure The authors report no conflict of interests in this work.
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