Central nervous system excitatory effects of meperidine in cancer patients

Annals of Neurology - Tập 13 Số 2 - Trang 180-185 - 1983
Robert F. Kaiko1,2, Kathleen M. Foley3,4,2, Patricia Y. Grabinski1, George Heidrich1, Ada G. Rogers1, Charles E. Inturrisi1,2, Marcus M. Reidenberg5,2
1Analgesic Studies Section, Cornell University Medical College, New York, NY
2Department of Pharmacology, Cornell University Medical College, New York, NY
3Department of Neurology, Cornell University Medical College, New York, NY.
4Department of Neurology, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, New York, NY
5Department of Medicine, Cornell University Medical College, New York, NY

Tóm tắt

AbstractThe analgesic meperidine has been reported to produce signs of central nervous system excitation in human beings. To determine the relationship between signs and symptoms of central nervous system excitation and plasma levels of meperidine and normeperidine, we studied 67 patients receiving meperidine for the relief of postoperative or chronic pain. In 48 patients, excitatory effects ranging from mild nervousness to tremors, twitches, multifocal myoclonus, and seizures were directly correlated with accumulation of normeperidine in plasma. Evidence of compromised renal function occurred in only 14 of the 48 symptomatic patients, suggesting that renal dysfunction may contribute to but is not the sole factor in the accumulation of normeperidine or its relation to adverse neurological signs. In a second study we surveyed mood alterations in 47 patients receiving meperidine and 29 receiving other narcotic analgesics for postoperative pain. The repeated administration of meperidine was associated with adverse alterations in various elements of mood (e.g., apprehension, sadness, restlessness).

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Annals of Neurology

Tập 13 Số 2

180-185

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