Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

Abstract

Background:Postoperative pain relief is important in procedures of the lower extremity. Several previous studies have evaluated the efficacy of intra-articular (IA) pethidine as a compound, which has local anesthetic and opioid agonist properties, on postoperative pain relief in arthroscopic knee surgery (AKS). This study compared the postoperative analgesic effect of pre- and post-surgical IA pethidine administration in AKS.Materials and Methods:Seventy-five patients of American Society of Anesthesiologists (ASA) I and II undergoing AKS with general anesthesia were enrolled in this double-blind study. Patients were randomized in three equal groups to receive either 50 mg IA pethidine before surgical incision incision and saline after skin closure (PS), saline before surgical incision and pethedine after skin closure (SP), and only saline at two different times (SS). In each patient with operated knee joint, pain at rest and joint movement was evaluated at 1, 2, 6, 12, and 24 h after surgery completion using Visual Analog Scale (VAS). Data were analyzed using analysis of variance (ANOVA)-repeated measure, t-paired, and Chi-square tests.Results:Postoperative pain score at rest and joint movement in PS group was significantly lower than those in other groups. The time (Mean ± SD) between completion of operation and patient's request for morphine, total morphine consumption (Mean ± SD) in postoperative 24 h, and the numbers of patients requesting analgesic in PS, SP, SS, groups were: 5.2 ± 1.3, 3.3 ± 1.5, and 2 ± 1.3 h (P < 0.05); 4.4 ± 2.4, 8.7 ± 2, and 11.6 ± 4.4 mg (P < 0.05); 11, 18, and 21 persons (P < 0.05), respectively.Conclusion:The present study shows that preemptive intra-articular pethidine 50 mg injection is more effective than preventive injection for postoperative pain relief at rest and joint movement in arthroscopic knee surgery.

Pethidine efficacy in achieving the ultrasound-guided oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: A prospective study

“…The analgesic effects of pethidine could be produced by at least three mechanisms: Systemic absorption, interaction with peripheral opioid receptors, and local anesthetic effects. Even though this was not a pharmacodynamic study, we can hypothesize [21,25] that the first two mechanisms (the systemic absorption and the interaction with peripheral opioid receptors) are responsible the most for the pain score results in the PACU. The third mechanism, local anesthetic effect of pethidine, may be responsible for the analgesic effect up to 24 hours, similar to the effect of 0.25% bupivacaine.…”

“…The electrophysiological studies showed that the administration of 1% pethidine is followed by sensory and motor block produced by the action on the peripheral nerves [14]. Pethidine is effective in many regional anesthesia techniques, such as subarachnoid, epidural, intra-articular, and regional intravenous anesthesia [20][21][22].…”

Fully Diastereoselective Synthesis of Polysubstituted, Functionalized Piperidines and Decahydroquinolines Based on Multicomponent Reactions Catalyzed by Cerium(IV) Ammonium Nitrate

“…We also examined the reduction of a selection of representative 6-alkoxy-1,4,5,6-tetrahydropyridines 5 under the same conditions, and obtained very similar results to those described for the dihydropyridines (Scheme 6). The starting materials for this study (5) are known compounds, [27] and the yields obtained in their reduction are summarized in Figure 3.…”

“…Pipradrol and desoxypipradrol4 are employed as stimulants that act as norepinephrine‐dopamine reuptake inhibitors (NDRI). Other piperidine derivatives with broad therapeutic use include pethidine (meperidine),5 an opioid analgesic drug, and risperidone6 and haloperidol,7 two potent antipsychotic drugs used for the treatment of schizophrenia that act as a dopamine inverse agonists.…”

“…Pipradrol and desoxypipradrol [4] are employed as stimulants that act as norepinephrine-dopamine reuptake inhibitors (NDRI). Other piperidine derivatives with broad therapeutic use include pethidine (meperidine), [5] an opioid analgesic drug, and risperidone [6] and haloperidol, [7] two potent antipsychotic drugs used for the treatment of schizophrenia that act as a dopamine inverse agonists. Decahydroquinolines are fully saturated nitrogen heterocycles that can be viewed as cyclohexane-fused piperidines; such compounds often have potent pharmacological activities, par-ticularly as nicotinic receptor antagonists.…”