Abbuhl S, Jacobson S, Murphy J G, Gibson G
Ann Emerg Med. 1986 Apr;15(4):433-8. doi: 10.1016/s0196-0644(86)80183-4.
We compared mean serum concentrations of meperidine in sickle cell patients in crisis and control patients receiving meperidine prior to incision and drainage of abscesses. Eight sickle cell and five control patients without confounding illnesses consented to participate and received 100 mg meperidine in the deltoid or gluteal muscle for pain. Blood samples were drawn at baseline, 0.25, 0.50, 0.75, 1.0, 1.5, and 2.0 hours postinjection. In the sickle cell group, mean peak concentration of meperidine was 0.32 +/- 0.08 micrograms/mL at an average of 0.5 +/- 0.07 hours postinjection. Among controls mean peak concentration was 0.72 +/- 0.37 micrograms/mL at an average of 0.6 +/- 0.11 hours. The difference in peak concentrations was significant at all time intervals (P less than .01); the difference in times to peak was not significant. We conclude that, given a standard dose, serum concentrations of meperidine differ between sickle cell and control patients, which may suggest reasons for the relatively poor pain control often noted in sickle cell patients.
我们比较了处于镰状细胞危象的患者与在脓肿切开引流术前接受哌替啶治疗的对照患者的哌替啶平均血清浓度。8名镰状细胞病患者和5名无混杂疾病的对照患者同意参与研究，并在三角肌或臀肌中注射100mg哌替啶以止痛。在注射后基线、0.25、0.50、0.75、1.0、1.5和2.0小时采集血样。在镰状细胞病组中，哌替啶的平均峰值浓度在注射后平均0.5±0.07小时为0.32±0.08μg/mL。在对照组中，平均峰值浓度在平均0.6±0.11小时为0.72±0.37μg/mL。在所有时间间隔内，峰值浓度的差异均具有统计学意义（P<0.01）；达到峰值的时间差异无统计学意义。我们得出结论，给予标准剂量时，镰状细胞病患者与对照患者的哌替啶血清浓度不同，这可能是镰状细胞病患者疼痛控制往往较差的原因。
