Background: Preliminary clinical studies have suggested that gabapentin may produce analgesia and reduce the need for opioids in postoperative patients. The aim of the present study was to investigate the opioid-sparing and analgesic effects of gabapentin administered during the first 24h after surgery. Materials & Methods: In a randomized, single-blind study 196 patients assigned to two groups receiving gabapentin (n=102) or placebo (n=94). Oral gabapentin 1200 mg or placebo, 2h before surgery, followed by oral gabapentin 600 mg or placebo 8, 16 and 24 h after the initial dose. Patients requesting analgesia received it with pethidine at dose of 25 mg (iv). Total pethidine consumption for each patient was recorded from zero to 24h postoperatively. Pain was assessed on a visual analogue scale (VAS), and vomiting, dizziness and somnolence were assessed. Results: Gabapentin reduced total pethidine consumption (P<0.001) and postoperative pain as well (P<0.001). It was associated with a significant increase in somnolence (P=0.007) and dizziness (P=0.019), however, no significant difference in vomiting (P=0.075) was observed.Conclusion: A total dose of 3000 mg gabapentin before and during the first 24h after surgery, reduces pain score and pethidine consumption, and increases the incidence of somnolence and dizziness.

Background: Cleft lip is one of the most common congenital anomalies in the world. There has been recently a considerable increase in use of local methods. In this regard, opioids are the common adjuvants but their safety and efficacy have not been studied extensively in children undergoing cleft lip repair. Therefore, we aimed to investigate the efficacy of local pethidine in comparison with intravenous pethidine in patients undergoing bilateral infraorbital nerve block.Methods: In this prospective, randomized, double-blind study, 40 children undergoing cleft lip repair allocated randomly to two groups. Group 1 received infraorbital injection of Marcaine and pethidine; and group 2 received infraorbital injection of Marcaine and intravenous pethidine. Statistical analysis was performed using SPSS software.Findings: The mean pain score was 5.15 ± 1.87 and 5.85 ± 2.10 in groups 1 and 2, respectively (P=0.21). There was no significant difference in postoperative analgesic requirements between the groups (P>0.05). There were no major complications in both groups.Conclusion: There was no significant differences between addition of pethidine to Marcaine and intravenous injection of pethidine in terms of postoperative pain score, duration of hospitalization, and postoperative analgesic requirements. Although no major complications were found, intravenous injection of pethidine is not suggested for cleft lip repair in children.

Background: Spinal anesthesia for elective cesarean section using drugs such as lidocaine has long been used with reports of various complications. To reduce these complications, many methods such as administration of sympathetic stimulating drugs like ephedrine, and using other drugs including pethidine have been recommended. The present study was aimed to evaluate comparatively the effects of separate and combined administration of pethidine and lidocaine on spinal anesthesia in candidates for cesarean surgery.Material and Methods: In this double blind clinical trial study, 150 cases with ASA I-II and full term neonatal, candidate for elective cesarean surgery from Zahedan Ghods Hospital and Ali- Ebene-Abitaleb Hospital, were subjected to the study during 2001-2004. They were randomly divided into three groups of 50, for using 5% lidocaine, 5% lidocaine plus 5% pethidine and 5% pethidine, respectively. A number of variables, including duration of postoperative analgesia, variation of homodynamic, heart rate, hypotension, nausea and vomiting were assessed. Statistical descriptive methods, one way ANOVA and X2 were used for the data analysis.Results: Breath depression was not seen in the neonates. The Apgar score was ³8. Duration of post operating analgesia was 453 minutes in pethidine group, 344.3 minutes in lidocaine plus pethidine group and 141.4 minutes in lidocaine group with significant differences (P<0.05). Differences of nausea and vomiting between groups were not significant.Conclusion: The longest duration of analgesia was seen with pethidine usage. The combination of pethidine and lidocaine was intermediately effective and seems to be suitable choice in anesthesia comparing to lidocaine alone.

The aim of this work was finding new flurescent dyes as sensitizers for chemiluminescence (CL) determination some of narcotics. In this way 6 different dyes incloding rhodamine 6G, brilliant blue, orange G, chromatrope, eosin Y and [Ru(phen)3]2+ and 14 drugs incloding pethidine hydrochloride, thebaine, dextromethorphan, acetaminophen, codeine, oxymorphone, oxycodone, morphine, pholcodine, naltrexone, buprenorphine, methadone, tramadol, diphenoxylate were investigated. In the preliminary experiments, we found that pethidine hydrochloride in CL system of [Ru(phen)3]2+- Ce(IV) and thebaine in CL system of rhodamine 6G- Ce(IV) could be determined. After optimizing the important variables, linear dynamic range for pethidine hydrochloride and thebaine were 5.6×10-7 to 1.4×10-3 mol L-1 and 1.0×10-5 to 4.0×10-4 mol L-1 and limit of detection were 7.1×10-8 mol L-1 and 4.3×10-6 mol L-1, respectively. The percent of relative standard deviation for pethidine hydrochloride and thebaine were 5.7 and 4.0%, respectively.

Background: Postoperative pain is a common phenomenon, and its management affects considerably on the recovery process, and patients’ satisfaction. Apotel and pethidine are two conventional medicines used to relieve pain after operation. Objectives: The present study aimed to compare the effect of intravenous injection of Apotel and intramuscular injection of pethidine in relieving pain after hemilaminectomy. Materials & Methods: In the present cross-sectional study, 150 patients who underwent hemilaminectomy were recruited between May 2015 and November 2015. They were taking either Apotel (n=75) or pethidine (n=75) after the operation, which was done at Poursina Hospital affiliated to Guilan University of Medical Sciences, Rasht City, Iran. The patients’ pain levels were measured using Visual Analog Scale (VAS), and the results were compared between the 2 groups. Results: There was no significant difference in the total VAS score between the Apotel and pethidine groups (P=0. 189). However, there was a significant reduction in VAS score hours 2 (P=0. 03) and 4 (P=0. 004) hours after the injection of Apotel in this group, compared with those scores in the pethidine group. Also, VAS scores at other times (8, 12, 20, 28 hours after the injection) were lower than those in the pethidine group, but the difference was not significant. Conclusion: Apotel was better pain-killer in the early hours after the first injection compared to pethidine. But its effect was similar to pethidine at the late hours after the first injection. Therefore it seems that Apotel is better painkiller after laminectomy, especially in the early hours after the operation.

Background & Aims: Post-operative shivering is very common and it is usually followed by many problems such as an increase in oxygen consumption, blood pressure, intracranial and intraocular pressure, and post-operation pain. Therefore, it is very important to prevent shivering especially in the elderly and ischemic heart disease patients. The goal of this study was comparing the effect of Pethidine (Meperidine), Dexamethasone, and Placebo in prevention of shivering.Materials & Methods: This double blind clinical trial study was carried out on 120 patients who were candidates for surgery under general anesthesia. The patients were randomly divided into three groups including those who received placebo (a) Dexamethasone (b) and Pethidine (c). Induction and maintenance of anesthesia for all patients were similar. Central and peripheral temperature of patients was measured every 5 minute interval. After induction saline normal, Dexamethasone and Pethidine were respectively injected to groups a, b, and c. In recovery, all patients were controlled for visible shivering: The data were statistically analyzed by SPSS software and ANOVA and chi square tests.Results: There were no significant differences among three mentioned groups regarding of gender, age, duration of surgery, and recovery time. Nineteen cases (47.5%) in groupa had post-operative shivering. Whereas, in groupb only 4 cases (10%) had shivering and the difference between 2 groups was significant (P value=0.001). Also in groupc, 15 cases (37.5%) had shivering that the difference with placebo group was significant (P value=0.08).Conclusion: The present study showed that pethidine and dexamethasone are effective drugs for preventing post-operative shivering in elective surgery. And the effect of dexamethasone in preventing the post-operative shivering is better than Pethidine. Dexamethasone can be administered after induction of anesthesia as an alternative to administration of Pethidine (as a common method of prevention and treatment of postoperative shivering) particularly in patients with hemodynamic instability.

Background and purpose: Shivering is a common and unpleasant side effect in post operation which is associated with other complications such as increased demands for oxygen, tension on suture line and increase of Intra Cranial Pressure. The purpose of this study was to compare the effects of tramadol and pethidine in controlling post-operative shivering.Materials and methods: A randomized controlled trial was carried out on 50 patients (aged 20 to 40 years) who were referred to operation room for general surgery or orthopedic surgery. The patients were randomly divided into two equal groups, one group received IV pethidine 25 mg and the group received IV tramadol 0.5 mg/kg. Post-operative shivering was assessed by direct observation.Results: There was a significant difference between the two groups in elapsed time to control of shivering (p=0.016). Vomiting was not seen in the both groups. Oxygen saturation was higher in tramadol group compared with pethidine group.Conclusion: Results demonstrated that tramadol is more effective than pethidine in controling shivering and this was associated with higher oxygen saturation. It seems that the tramadol is an appropriate replacement for pethidine which is commonly used to control post-operative shivering.Further studies with more samples are recommended.

Pethidine (meperidine) was discovered in 1939 and has long been recognized as an analgesic in routine clinical practice (1). Painless delivery is one of the oldest fields in which this drug has been used for analgesia (2). In recent years, many concerns have been raised regarding the use of pethidine as an analgesic (3). Seizures are a major concern with meperidine use, as it is one of the drugs with high epileptogenic potential (4). Normeperidine, a neurotoxic metabolite of meperidine, is known to be the primary culprit in causing seizures. Although the risks of pethidine use in patients with liver dysfunction are well established, long-term use, especially at high doses, can also be hazardous for individuals without hepatic impairment. The key factor is the individual's cytochrome system, which determines the production of this dangerous metabolite (5).

Background: Non-steroidal anti-inflammatory drugs (NSADs) and opioids are frequently administered to relieve postoperative pain. Uncontrolled postoperative pain may produce a range of detrimental acute and chronic health consequences and increase mortality and morbidity. Practically, the analgesic efficacy of opioids is typically limited by the development of tolerance to them or by opioid-related sideeffects such as nausea, vomiting, sedation or respiratory depression. This study aims to assess the effects of suppository diclofenac on post-herniorrhaphy pain management.Methods: In this prospective double-blind clinical trial, 60 patients who were candidate for the surgical repair of inguinal hernia were divided into two groups. Patients in group A received 100 mg of suppository diclofenac and patients in group B 50 mg of pethidine after the induction of anesthesia and before surgical incision. Postoperative pain assessment was done by an unbiased observer on the arrival of patients in the recovery room, using a 10-cm visual analogue scale (VAS) at 2-hour intervals for 6 hours.Results: Pain relief was similar in the two groups (P=0.3). Patients in group B required more analgesia two hours post-operatively (P=0.03), while patients in group A had more favorable results regarding pain control (P<0.05). Statistically, there was no difference between the two groups at other intervals. The occurrence of nausea and vomiting was similar in both groups. No respiratory depression was observed in the patients.Conclusion: Preventive analgesia with 100 mg of suppository diclofenac after anesthesia induction for herniorrhaphy produced effective postoperative analgesia with minimum side-effects.