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The article entitled "Prevalence of Meperidine Use in Older Surgical Patients" by Kornitzer et al¹ has brought a very important issue about the adverse effects of meperidine hydrochloride use in older surgical patients with or without compromised renal function. The authors have quoted a book of 1739 pages, without any reference to page or chapter, published by the American College of Surgeons² saying that meperidine is "suboptimal analgesia for postoperative patients."

It is well known that meperidine's metabolite, normeperidine, is a potentially toxic and can cause seizure disorders in elderly patients. But we do not know the blood level of normeperidine that will cause a seizure disorder.

The recommended dose of meperidine hydrochloride for elderly patients is 200 mg/d for a period of 48 to 72 hours. Such a small dose of meperidine should not cause a seizure disorder unless other causes of seizure disorder exist. Furthermore, use of such . . . [Full Text of this Article]

AUTHOR INFORMATION
M. Badruddoja, MD, FRCS, FRACS, FICS