Pharmacokinetics of high-dose meperidine in surgical patients

Adolph Koska, W. G. Kramer, A. Romagnoli, A. S. Keats, P. B. Sabawala

Research output: Contribution to journalArticle

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Abstract

Intravenous meperidine is used during surgical procedures at doses up to 5 mg/kg. At the commonly used analgesic intravenous doses of 50 to 100 mg (0.7 to 1.4 mg/kg), the drug exhibits two-compartment open model pharmacokinetics, with elimination primarily by hepatic metabolism (>90% of a dose). Drugs eliminated to a large extent by metabolism may, however, be subject to dose-dependent kinetics. We therefore studied the pharmacokinetics of meperidine when administered as 5 mg/kg IV bolus injections in surgical patients undergoing corrective vascular surgery involving the lower part of the abdominal aorta and the femoral and popliteal arteries. Serial blood samples were collected over 10 hours and plasma meperidine concentrations were determined by a gas chromatographic assay. Semilogarithmic plots of plasma meperidine concentration vs time were biphasic; however, the curves' irregularities during the time the arterial vessels were clamped suggest that the data should be analyzed in a model-independent manner. These irregularities suggest that the disposition of meperidine is altered during the clamping period and that these alterations are quickly reversed following removal of the clamp. Our findings agree with those reported in the literature following a total dose of 50 mg (half-life average 4.4 hours, total plasma clearance 10.4 ml/min/kg, and apparent volume of distribution 3.74 L/kg). The present results thus indicate that although meperidine is eliminated to a large extent by metabolism, the processes involved are apparently not saturated at doses 7 times greater than normal.

Original languageEnglish (US)
Pages (from-to)8-11
Number of pages4
JournalAnesthesia and Analgesia
Volume60
Issue number1
StatePublished - 1981
Externally publishedYes

Fingerprint

Meperidine
Pharmacokinetics
Popliteal Artery
Abdominal Aorta
Femoral Artery
Constriction
Pharmaceutical Preparations
Blood Vessels
Half-Life
Analgesics
Gases
Injections

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Koska, A., Kramer, W. G., Romagnoli, A., Keats, A. S., & Sabawala, P. B. (1981). Pharmacokinetics of high-dose meperidine in surgical patients. Anesthesia and Analgesia, 60(1), 8-11.

Pharmacokinetics of high-dose meperidine in surgical patients. / Koska, Adolph; Kramer, W. G.; Romagnoli, A.; Keats, A. S.; Sabawala, P. B.

In: Anesthesia and Analgesia, Vol. 60, No. 1, 1981, p. 8-11.

Research output: Contribution to journalArticle

Koska, A, Kramer, WG, Romagnoli, A, Keats, AS & Sabawala, PB 1981, 'Pharmacokinetics of high-dose meperidine in surgical patients', Anesthesia and Analgesia, vol. 60, no. 1, pp. 8-11.
Koska A, Kramer WG, Romagnoli A, Keats AS, Sabawala PB. Pharmacokinetics of high-dose meperidine in surgical patients. Anesthesia and Analgesia. 1981;60(1):8-11.
Koska, Adolph ; Kramer, W. G. ; Romagnoli, A. ; Keats, A. S. ; Sabawala, P. B. / Pharmacokinetics of high-dose meperidine in surgical patients. In: Anesthesia and Analgesia. 1981 ; Vol. 60, No. 1. pp. 8-11.
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