Parenteral Meperidine: a Review of the Pharmacology and Clinical Applications

This article examines historical clinical applications of meperidine in the perioperative setting while reviewing the pharmacology, adverse effects, and special considerations. The purpose of this article is to re-evaluate the literature ultimately to answer the question, “Is there still a role for meperidine in the perioperative setting?” This narrative review was prepared through a comprehensive search strategy of medical literature databases including PubMed, Google Scholar, and Ovid among others using terminology related to meperidine and its known clinical a pplications (i.e., shivering, neuraxial, labor).Recent FindingsClinicians explored a breadth of indications for meperidine, a unique opioid compound with multiple pharmacologic properties originally synthesized in 1939. These uses include analgesia, local anesthesia, smooth muscle, and questionable anticholinergic properties with applications for biliary colic, spinal anesthesia, and postoperative analgesia. Despite the broad range of historical applications, meperidine use overall in the USA has diminished secondary to newer alternatives with more favorable adverse effect profiles.SummaryWith the reduction in use of meperidine overall, many question the utility of maintaining meperidine on hospital formularies. Treatment of postoperative shivering remains an effective niche indication of meperidine. Ultimately, we acknowledge the role for continued use for narrowed indications such as postoperative shivering.
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research