THE PERIPHERAL ANALGESIC EFFECT OF MEPERIDINE IN REDUCING PROPOFOL INJECTION PAIN IS NOT NALOXONE-REVERSIBLE

Background and Objectives. Meperidine is frequently used in general an esthesia and perioperative analgesia. In addition to its opioid action , meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidin e to be more effective in reducing propofol injection pain than fentan yl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic eff ect of meperidine is affected by naloxone. Methods. In a randomized, d ouble-blind manner, after venous occlusion with a tourniquet, meperidi ne 40 mg was given intravenously to patients in group A (n = 31), mepe ridine 40 mg followed by naloxone 0.04 mg to group B (n = 32), meperid ine 40 mg followed by naloxone 0.2 mg to group C (n = 30), and normal saline placebo to group D (n = 30). The venous retention of drug(s) wa s maintained for 1 minute, followed by tourniquet release and intraven ous administration of propofol 100 mg. Pain assessment was made immedi ately after the propofol injection. Results. All three groups given me peridine had significantly less propofol injection pain (P <.01) than the group given saline placebo, and there was no difference among grou ps A, B, and C. Conclusion. The peripheral analgesic effect of meperid ine in reducing propofol injection pain is not mediated by its opioid activity.