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meperidine-induced Seizure in an Adult Patient with Lung Lesions

Chinese Medical Journal 2016年第3期129卷 370-371页

作者： Wei Luo Ya-Lun Li Qi YU Yi-Shi Li Shu-Liang Guo Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical University Chongqing 400016 China Department of Respiratory and Critical Care Medicine West China Hospital Sichuan University Chengdu Sichuan 610041 China Department of Pediatrics The Leshan People's Hospital Leshan Sichuan 614000 China

To the Editor： meperidine, also known as pethidine, is one of the most commonly prescribed opioid analgesics.meperidine exerts high central nervous system depressant effects through producing prolonged activation of opioid receptors （μ-receptor）.We described a rare case of generalized tonic-clonic seizures after intravenous （Ⅳ） injection of meperidine for bronchoscopy premedication in a patient with a lung lesion who lacked a prior history of seizures.

关键词： meperidine pethidine Lesions

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Comparative effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on preventing post-spinal anesthesia shivering and adverse events in hip fracture repair patients:A randomized clinical trial

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Journal of Acute Disease 2022年第6期11卷 222-227页

作者： Mansoreh Kokhaei Hesameddin Modir Esmail Moshiri Mehran Azami Students Research Committee Arak University of Medical SciencesArakIran Departments of Anesthesiology and Critical Care Arak University of Medical SciencesArakIran Departments of Orthopedic Surgery Arak University of Medical SciencesArakIran

Objective:To compare effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on the prevention of post-spinal anesthesia shivering and adverse events in hip fracture repair patients.Methods:In a randomized,double-blind trial,132 patients with American Society of Anesthesiology(ASA)ⅠandⅡspinal anesthesia who needed hip fracture surgery were enrolled.Patients were stratified into 4 intervention groups based on a randomized block pattern:meperidine,tramadol,magnesium sulfate,and dexmedetomidine.Hemodynamic parameters including blood pressure,heart rate,and oxygen saturation,as well as the severity of shivering,core body temperature,Ramsay sedation score,adverse events,meperidine consumption were recorded and compared.Results:There was no statistically significant difference in the normal hemodynamic parameters,temperature,duration of surgery,meperidine consumption,and adverse events such as dizziness,hypotension,nausea,and bradycardia among groups(P>0.05).Compared to other groups,severity of shivering was the lower in the dexmedetomidine group 6 and 8 h after surgery.The Ramsay sedation scores were higher in the dexmedetomidine and meperidine groups 4 h after surgery(P=0.020).Conclusion:Dexmedetomidine acts better than the other three adjuvants in reducing complications such as shivering.Overall,these four adjuvants are helpful to prevent postoperative shivering and could be put forward as promising local anesthetics in spinal anesthesia,based on anesthesiologists’discretion and patients’general conditions.Clinical registration:The study was approved by the Research and Ethics Committee at the Valiasr Hospital(Arak,Iran)with the clinical trial code of IRCT20141209020258N153.

关键词： Dexmedetomidine Hip fracture Intrathecal injec-tion Magnesium sulfate meperidine Shivering Spinal Tramadol

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Conscious sedation: A dying practice?

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World Journal of Gastroenterology 2013年第28期19卷 4633-4634页

作者： Palaniappan Manickam Ziad Kanaan Khalid Zakaria Division of Gastroenterology Department of the Internal Medicine Oakland University William Beaumont School of Medicine Royal Oak MI 48037 United States Department of Internal Medicine Wayne State University Rochester MI 48307 United States

Sedation practices vary according to countries with different health system regulations, the procedures done, and local circumstances. Interestingly, differences in the setting in which the practice of gastroenterology and endoscopy takes place (university-based vs academic practice) as well as other systematic practice differences influence the attitude of endoscopists concerning sedation practices. Conscious sedation using midazolam and opioids is the current standard method of sedation in diagnostic and therapeutic endoscopy. Interestingly, propofol is a commonly preferred sedation method by endoscopists due to higher satisfaction rates along with its short half-life and thus lower risk of hepatic encephalopathy. On the other hand, midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. The administration of sedation under the supervision of a properly trained endoscopist could become the standard practice and the urgent development of an updated international consensus regarding the use of sedative agents like propofol is needed.

关键词： Sedation Conscious Endoscopy Propofol Fentanyl meperidine

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