Clark R F, Wei E M, Anderson P O
Dept. of Emergency Medicine, UCSD Medical Center, San Diego, CA 92103-8676, USA.
J Emerg Med. 1995 Nov-Dec;13(6):797-802. doi: 10.1016/0736-4679(95)02002-0.
Meperidine is a synthetic opioid analgesic frequently prescribed in the emergency department. Meperidine is most often administered intramuscularly or intravenously, due to its poor oral bioavailability, and is metabolized extensively by the liver. Analgesic effects usually last 3-4 hours with parenteral administration, and some adverse effects such as nausea may be reduced when meperidine is combined with antiemetic or antihistaminic medications. Although meperidine is often a preferred analgesic by both patients and physicians in the treatment of disorders such as migraine headaches, its analgesic efficacy has rarely proven superior to alternative parenteral pain medications in controlled trials. In addition, meperidine can precipitate monoamine oxidase inhibitor reactions, and during metabolism it is demethylated to normeperidine, a compound with significant central nervous system (CNS) toxicity. Meperidine should be considered a second line agent in the treatment of pain when opioid analgesics are required.
哌替啶是急诊科常用的一种合成阿片类镇痛药。由于其口服生物利用度差，哌替啶最常通过肌肉注射或静脉注射给药，且在肝脏中广泛代谢。肠胃外给药时，镇痛效果通常持续3至4小时，当哌替啶与止吐药或抗组胺药合用时，恶心等一些不良反应可能会减轻。尽管在治疗偏头痛等疾病时，哌替啶常常是患者和医生偏爱的镇痛药，但在对照试验中，其镇痛效果很少被证明优于其他肠胃外止痛药。此外，哌替啶可引发单胺氧化酶抑制剂反应，在代谢过程中会脱甲基形成去甲哌替啶，这是一种具有显著中枢神经系统（CNS）毒性的化合物。当需要使用阿片类镇痛药治疗疼痛时，哌替啶应被视为二线药物。
