No abstract available.
Calculi/*therapy ; Female ; Humans ; *Lithotripsy ; Male ; Meperidine/*administration & dosage

BACKGROUND: The objectives of this study were to assess propofol as sedative agents for colonoscopy in the safety and efficacy, compared with midazolam plus meperidine. METHODS: 120 patients undergoing colonoscopy in a prospective study were randomly assigned to one of three medication regimens. Patients in group A (n=42) received i.v. 25 mg of meperidine and 2.5 mg of midazolam. Patients in group B (n=41) received i.v. a median dose of 96.59 mg of propofol (range 40-180) and patients in group C (n=37) received i.v. 25 mg of meperidine and a median dose of 77.03 mg of propofol (range 40-150), administered by a nurse with endoscopist supervision. Endpoints were patient satisfaction, procedure and recovery times and complications. RESULTS: The mean time to sedation was much faster in 2 groups using propofol (group A: 152+/-105.9 sec, group B: 52.9+/-46.5 sec, group C: 56+/-63.7sec; p<0.001). The mean time to reach the cecum was not different among the 3 groups. There were total 3 episodes of oxygen desaturation to <90%, as one in each group, but the patients were spontaneously recovered with only increasing O2 concentration and arousal. Patients in group C expressed better overall mean satisfaction than patients in group A (p=0.049), but difference was not found between group A and group B. The amnestic effect was better in two groups using propofol than group A (p=0.017) The mean dose of propofol was lower in the patients who received propofol combined with low dose of meperidine than those with propofol only (77.03 mg vs 96.59 mg, p=0.009). CONCLUSION: Nurse-administered propofol sedation with endoscopist supervision is believed to be safe and useful for colonoscopy with careful monitoring.
Arousal ; Cecum ; Colonoscopy ; Conscious Sedation* ; Humans ; Meperidine ; Midazolam ; Organization and Administration ; Oxygen ; Patient Satisfaction ; Propofol* ; Prospective Studies*

Among the elective Surgeries performed at Hanyang University Hospital from March to July 1986, 150 cases were studied. Each 50 cases were given diazepam, lorazepam and mep-eridine as prefnedicants. In the diazepam and lorageparm group, each 25 cases were given by intramuscvlary and intravenously. 40 minutes after injection, scoring the degree of sedation was performed. Scoring the degree of sedation was adopted by "Simple Scoring System" (Nisbet and Norria, 1963). The results were as follows : 1) Comparison of diazepam, lorazepam and meperidine intramusclar administration, sign-ificantly lower souring wan defined in meperidine. (p<0.05 7r riait analysis) 2) Comparison of scoring in intramuscular and intravenous administration of diagepam and lorazepam, no significance were defined in both groups. (p>0.05 by ridit analrsis in both groups) 3) Environmental factors (sex, grade of education, religion and sits of operation) were not influenced on scoring significantly. (p>0.05 by Chi-square test)
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Administration, Intravenous ; Diazepam* ; Education ; Lorazepam* ; Meperidine*

BACKGROUND/AIMS: Patient-controlled sedation (PCS) allows the patients to titrate the dosages of sedative drug according to their needs. The objective of this study was to compare the safety and the efficacy of nurse-administered propofol sedation (NAPS) with those of PCS. METHODS: Eighty one patients were randomly assigned to two groups. All patients received meperidine 25 mg and propofol 40 mg as an initial dose for sedation. Patients in PCS group were subsequently infused with propofol 15 mg over 80 seconds through infusion pump whenever they required. Patients in NAPS group were injected with 10~20 mg propofol by nurse with supervision by endoscopist. The dosage of propofol, cardiopulmonary parameters, procedure time, sedation score, pain score, the patients' and endoscopists' satisfaction scores were assessed. RESULTS: With regard to blood pressure, pulse rate and oxygen saturation, serious complications were not observed. Especially, there was no significant difference of mean total dose between two groups (NAPS group and PCS group received 76.7+/-24.7 mg and 82.5+/-26.6 mg respectively). Pain score was higher in woman than in man (p=0.03). CONCLUSIONS: 1.2~1.5 mg/kg of propofol with small dose of opioid during colonoscopy was effective and safe. NAPS was more practical and useful method of sedation than PCS during colonoscopy.
Blood Pressure ; Colonoscopy* ; Female ; Heart Rate ; Humans ; Infusion Pumps ; Meperidine ; Organization and Administration ; Oxygen ; Propofol*

BACKGROUND: Patients who undergo urinary catheterization may experience postoperative catheter-related bladder discomfort (CRBD). Previous studies have indicated that drugs with antimuscarinic effects could reduce the incidence and severity of CRBD. Accordingly, this study was carried out to investigate whether nefopam, a centrally acting analgesic with concomitant antimuscarinic effect, reduces the incidence and severity of CRBD. METHODS: Sixty patients with American Society of Anesthesiologists physical status I and II and aged 18–70 years who were scheduled to undergo elective ureteroscopic litholapaxy participated in this double-blinded study. Patients were divided into control and nefopam groups, comprising 30 patients each. In the nefopam group, 40 mg nefopam in 100 ml of 0.9% saline was administered intravenously. In the control group, only 100 ml of 0.9% saline was administered. All patients had a urethral catheter and ureter stent inserted during surgery. The incidence and severity of CRBD, numerical rating scale (NRS) score of postoperative pain, rescue pethidine dose, and side effects were recorded in the post-anesthesia care unit after surgery. RESULTS: The incidence (P = 0.020) and severity (P < 0.001) of CRBD were significantly different between the control group and the nefopam group. The NRS score of postoperative pain (P = 0.006) and rescue dose of pethidine (P < 0.001) were significantly higher in the control group than in the nefopam group. CONCLUSIONS: Intravenous administration of nefopam in patients scheduled to undergo ureteroscopic litholapaxy reduced the incidence and severity of CRBD, NRS score of postoperative pain and analgesic requirements.
Administration, Intravenous ; Humans ; Incidence ; Lithotripsy* ; Meperidine ; Nefopam* ; Pain, Postoperative ; Stents ; Ureter ; Ureteroscopy ; Urinary Bladder* ; Urinary Catheterization ; Urinary Catheters

Intraspinal narcotic anesthesia was performed in 180 open heart surgery patients. 0.1 mg/Kg of morphine or 1.5 mg/Kg of meperidine was administered as the primary anesthetic in the subarachnoid space using the barbotage technique. Of the 180 patients scheduled for open heart surgery, morphine was administered to 95 patients, meperidine to 55 and a mixture of morphine and meperidine to 30 patients. From a clinical point of view, there were no significant cardiovascular problems, however, respiratory depression seemed to be most serious after morphine administration. Mild complications such as pruritus (11.1%), voiding difficulty (10.6%), intraoperative awareness (4.4%) and spinal headache were observed, however these were mild, not major clinical problems and were acceptable. Postoperative analgesic effect and respiratory controllability were excellent.
Anesthesia, Spinal/adverse effects/*methods ; *Cardiac Surgical Procedures ; Humans ; Meperidine/*administration & dosage/adverse effects ; Morphine/*administration & dosage/adverse effects ; Respiratory Insufficiency/chemically induced

OBJECTIVETo observe analgesic effect of acupuncture compound anesthesia for patients of different pain thresholds.

METHODSSeven hundred cases of infertility who will be taken ova under ultrasound guidance via the va gina and receive in vitro fertilization and embryo transfer (IVF-ET), were randomly divided into an acupuncture compound anesthesia group (n = 347) and a simple Dolantin group (n = 353). The pain thresholds in the acupunc ture compound anesthesia group was determined 30 min before acupuncture on one day before taking ova, and in the simple Dolantin group was determined before injection of Dolantin and 30 min before taking the ova. The patients in the two groups respectively received electroacupuncture at Shenshu (BL 23), Ciliao (BL 32), Baihui (GV 20), Sanyinjiao (SP 6), etc. combined with intramuscular injection of Dolantin, and simple intramuscular injection of Do lantin.

RESULTSFor the patients with pain thresholds of 1 mA, 1.5 mA and 2 mA, the cumulative scores of pain in the acupuncture compound anesthesia group were significantly lower than those in the simple dolantin group (P < 0.01, P < 0.05). For the patients with pain thresholds of 0.5 mA, 2.5 mA and 3 mA, in cumulative scores of pain there were no significant differences between the two groups (P > 0.05).

CONCLUSIONFor the patients with moderate pain thresholds, acupuncture compound anesthesia has good analgesic effect.

Acupuncture Analgesia ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Meperidine ; administration & dosage ; Pain ; drug therapy ; physiopathology ; Pain Management ; Pain Threshold

BACKGROUND/AIMS: Colonoscopy is a painful procedure. Therefore conscious sedation is often used. However, the value of adding analgesics to sedatives has not been well evaluated. METHODS: The double blind, randomized controlled trial was carried out to compare patients' and endoscopist' assessments in both groups of patients: MP (Midazolam/Placebo) group (n=49) received midazolam plus placebo and MM (Midazolam/Meperidine) group (n=51) received midazolam plus meperidine. RESULTS: There was no significant difference of baseline characteristics except previous operation history. There were no significant difference of grade of tolerance, pain and willingness to another colonoscopy between the two groups. In endoscopist' satisfaction, the degree of difficulty was higher in MP group than in MM group (39.0 vs. 31.7,p<0.05). After the colonoscopy, systolic blood pressure, oxygen saturation, and pulse rate were significantly decreased (p<0.05) in both groups. However, there was no difference in the degree of decrease between the two groups. The incidence of adverse effect was not different in the two groups. However, one case of orthostatic hypotension with presyncope was noted in MM group. CONCLUSIONS: Adding meperidine to the midazolam before the colonoscopy does not seem to bring more beneficial effect to patients, whereas endoscopist favored the use of both medications.
Adult ; Aged ; Analgesics, Opioid/*administration & dosage/adverse effects ; *Colonoscopy ; Comparative Study ; Double-Blind Method ; English Abstract ; Female ; Humans ; Hypnotics and Sedatives/*administration & dosage/adverse effects ; Male ; Meperidine/*administration & dosage/adverse effects ; Midazolam/*administration & dosage/adverse effects ; Middle Aged

Recently several reports have described the usefulness of meperidine as the sole agent for spinal anesthesia. In this study, meperidine 50mg mixed with 10% dextrose 0.5ml was used for the spinal anesthetic agent for Cesarean section in 182 cases. The subarachnoid injection of meperidine resulted in anesthesia similar to that noted with the intrathecal administration of local anesthetics. Sensory and motor blockades in all patients with meperidine spinal anesthesia were obtained. Prolonged analgesic effect (453.7 +/- 158.1 minutes) and rapid motor recovery (75.9 +/- 17.2 minutes) were obtained. Side effects included nausea (49 patients), hypotension (95 patients) and pruritus (30 patients). Hypotension was easily treated with rapid hydration and ephedrine. Eighteen patients complained of mild pain during the last period of operation. At birth, all newborns cried immediately and the mean Apgar scores were 9.8 +/- 0.4 at one minute and 10 at 5 minutes. It is concluded that meperidine, which has advantages such as rapid motor recovery, prolonged postoperative analgesia, and mild complications which may be easily treated, can serve as a good alternative agent for spinal anesthesia for Cesarean section.
Adult ; *Anesthesia, Epidural ; *Anesthesia, Obstetrical ; *Cesarean Section ; Female ; Humans ; Infant, Newborn ; Injections, Spinal ; Meperidine/*administration & dosage/adverse effects ; Middle Aged ; Pregnancy

BACKGROUND/AIMS: A retrospective analysis was performed to evaluate the safety and effectiveness of extracorporeal shock wave lithotripsy (ESWL) for pancreatolithiasis on successive days under intravenous bolus of pethidine alone. METHODS: Ninety patients with calcified pancreatic stones (> or =5 mm) presenting with abdominal pain were selected for ESWL. ESWL was performed with an electroconductive lithotripter under fluoroscopic target systems. Fragmented calculi after ESWL were removed by endotherapy. RESULTS: A mean of 4.2 ESWL sessions were performed for each patient, with a mean of 2,984 shocks at a mean power setting of 12.8 kV. Eighty-four (89.3%) patients underwent ESWL for three or more days in a row. Fragmentation of the stones were achieved in 83/90 (92.2%) patients. Complete clearance of the main pancreatic duct was achieved in 54/90 (60.0%) patients, and partial clearance was achieved in 27 (30.0%) patients. The mean dose of pethidine used during ESWL was 53.5+/-20.7 mg per session. As ESWL-related complications, four (4.3%) patients developed mild acute pancreatitis. CONCLUSIONS: In case of endoscopically difficult-to-treat pancreatic duct stones, combined therapy with ESWL is an effective method, and treatment with multiple sessions of ESWL on successive days under intravenous bolus of pethidine alone is safe and well tolerated.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Calculi/*therapy ; Female ; Fluoroscopy ; Humans ; Injections, Intravenous ; *Lithotripsy ; Male ; Meperidine/*administration & dosage ; Middle Aged ; Pancreatic Ducts ; Pancreatitis/therapy ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome