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. 1982 May;13(5):653–659. doi: 10.1111/j.1365-2125.1982.tb01432.x

Maternal kinetics and transplacental passage of pethidine during labour.

G Tomson, R I Garle, B Thalme, H Nisell, L Nylund, A Rane
PMCID: PMC1402094  PMID: 7082532

Abstract

1 Pethidine is commonly used in single doses as an analgesic in obstetrics. Plasma concentration-time profiles of pethidine after intramuscular administration of 1.5 mg/kg body weight to 16 pregnant women during labour were investigated. There was only a two-fold variation in peak plasma concentration (300-650 ng/ml). The mean (+/- s.d.) value of the apparent plasma half-life of pethidine was 3.4 (+/- 1.0) h which is not different from that in healthy controls. norpethidine plasma levels were not measurable (less than 10 ng/ml). 2 The placental transfer transfer of pethidine was studied at delivery in samples from the umbilical cord vessels and from a maternal peripheral vein. In another 14 patients serial determinations of pethidine concentration were made in foetal scalp blood and maternal venous blood simultaneously during the different stages of labour. The foeto-maternal drug ratio varied between 0.35 and 1.5 with a positive correlation between ratio and dose delivery time interval. The concentration of pethidine in umbilical cord plasma or blood varied between 60 and 400 ng/ml with dose-delivery time intervals of 30 min to 10.5 h. The foetal concentration of pethidine reached a peak-plateau value between 1-5 h after dose.

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Selected References

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  1. BURNS J. J., BERGER B. L., LIEF P. A., WOLLACK A., PAPPER E. M., BRODIE B. B. The physiological disposition and fate of meperidine (demerol) in man and a method for its estimation in plasma. J Pharmacol Exp Ther. 1955 Jul;114(3):289–298. [PubMed] [Google Scholar]
  2. Beckett A. H., Taylor J. F. Blood concentrations of pethidine and pentazocine in mother and infant at time of birth. J Pharm Pharmacol. 1967 Dec;19(Suppl):50S–52S. [PubMed] [Google Scholar]
  3. Belfrage P., Boréus L. O., Hartvig P., Irestedt L., Raabe N. Neonatal depression after obstetrical analgesia with pethidine. The role of the injection-delivery time interval and of the plasma concentrations of pethidine and norpethidine. Acta Obstet Gynecol Scand. 1981;60(1):43–49. doi: 10.3109/00016348109154108. [DOI] [PubMed] [Google Scholar]
  4. Brackbill Y., Kane J., Manniello R. L., Abramson D. Obstetric premedication and infant outcome. Am J Obstet Gynecol. 1974 Feb 1;118(3):377–384. doi: 10.1016/s0002-9378(16)33797-8. [DOI] [PubMed] [Google Scholar]
  5. Caldwell J., Wakile L. A., Notarianni L. J., Smith R. L., Correy G. J., Lieberman B. A., Beard R. W., Finnie M. D., Snedden W. Maternal and neonatal disposition of pethidine in childbirth--a study using quantitative gas chromatography-mass spectrometry. Life Sci. 1978 Feb;22(7):589–596. doi: 10.1016/0024-3205(78)90338-7. [DOI] [PubMed] [Google Scholar]
  6. Cooper L. V., Stephen G. W., Aggett P. J. Elimination of pethidine and bupivacaine in the newborn. Arch Dis Child. 1977 Aug;52(8):638–641. doi: 10.1136/adc.52.8.638. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Crawford J. S., Rudofsky S. The placental transmission of pethidine. Br J Anaesth. 1965 Dec;37(12):929–933. doi: 10.1093/bja/37.12.929. [DOI] [PubMed] [Google Scholar]
  8. Evans J. M., Hogg M. I., Rosen M. Reversal of narcotic depression in the neonate by nalozone. Br Med J. 1976 Nov 6;2(6044):1098–1100. doi: 10.1136/bmj.2.6044.1098. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gerhardt T., Bancalari E., Cohen H., Macias-Loza M. Respiratory depression at birth--value of Apgar score and ventilatory measurements in its detection. J Pediatr. 1977 Jun;90(6):971–975. doi: 10.1016/s0022-3476(77)80574-x. [DOI] [PubMed] [Google Scholar]
  10. Hartvig P., Karlsson K. E., Lindbert C., Boréus L. O. Simultaneous determination of therapeutic plasma concentrations of pethidine and norpethidine in man by electron capture gas chromatography. Eur J Clin Pharmacol. 1977;11(1):65–69. doi: 10.1007/BF00561790. [DOI] [PubMed] [Google Scholar]
  11. Hogg M. I., Wiener P. C., Rosen M., Mapleson W. W. Urinary excretion and metabolism of pethidine and norpethidine in the newborn. Br J Anaesth. 1977 Sep;49(9):891–899. doi: 10.1093/bja/49.9.891. [DOI] [PubMed] [Google Scholar]
  12. Klotz U., McHorse T. S., Wilkinson G. R., Schenker S. The effect of cirrhosis on the disposition and elimination of meperidine in man. Clin Pharmacol Ther. 1974 Oct;16(4):667–675. doi: 10.1002/cpt1974164667. [DOI] [PubMed] [Google Scholar]
  13. Kuhnert B. R., Kuhnert P. M., Prochaska A. L., Sokol R. J. Meperidine disposition in mother, neonate, and nonpregnant females. Clin Pharmacol Ther. 1980 Apr;27(4):486–491. doi: 10.1038/clpt.1980.68. [DOI] [PubMed] [Google Scholar]
  14. Kuhnert B. R., Kuhnert P. M., Tu A. S., Lin D. C., Foltz R. L. Meperidine and normeperidine levels following meperidine administration during labor. I. Mother. Am J Obstet Gynecol. 1979 Apr 15;133(8):904–908. doi: 10.1016/0002-9378(79)90310-7. [DOI] [PubMed] [Google Scholar]
  15. Kuhnert B. R., Kuhnert P. M., Tu A. S., Lin D. C. Meperidine and normeperidine levels following meperidine administration during labor. II. Fetus and neonate. Am J Obstet Gynecol. 1979 Apr 15;133(8):909–914. doi: 10.1016/0002-9378(79)90311-9. [DOI] [PubMed] [Google Scholar]
  16. MILLER J. W., ANDERSON H. H. The effect of N-demethylation on certain pharmacologic actions of morphine, codeine, and meperidine in the mouse. J Pharmacol Exp Ther. 1954 Oct;112(2):191–196. [PubMed] [Google Scholar]
  17. Mather L. E., Lindop M. J., Tucker G. T., Pflug A. E. Pethidine revisited: plasma concentrations and effects after intramuscular injection. Br J Anaesth. 1975 Dec;47(12):1269–1275. doi: 10.1093/bja/47.12.1269. [DOI] [PubMed] [Google Scholar]
  18. Mather L. E., Meffin P. J. Clinical pharmacokinetics of pethidine. Clin Pharmacokinet. 1978 Sep-Oct;3(5):352–368. doi: 10.2165/00003088-197803050-00002. [DOI] [PubMed] [Google Scholar]
  19. Mather L. E., Tucker G. T., Pflug A. E., Lindop M. J., Wilkerson C. Meperidine kinetics in man. Intravenous injection in surgical patients and volunteers. Clin Pharmacol Ther. 1975 Jan;17(1):21–30. doi: 10.1002/cpt197517121. [DOI] [PubMed] [Google Scholar]
  20. Moore G., Nation R. Letter: Pharmacokinetics of meperidine in man. Clin Pharmacol Ther. 1976 Apr;19(4):486–488. doi: 10.1002/cpt1976194486. [DOI] [PubMed] [Google Scholar]
  21. Moore J., McNabb T. G., Glynn J. P. The placental transfer of pentazocine and pethidine. Br J Anaesth. 1973 Jul;45(Suppl):798–801. [PubMed] [Google Scholar]
  22. Morrison J. C., Whybrew W. D., Rosser S. I., Bucovaz E. T., Wiser W. L., Fish S. A. Metabolites of meperidine in the fetal and maternal serum. Am J Obstet Gynecol. 1976 Dec 15;126(8):997–1002. doi: 10.1016/0002-9378(76)90691-8. [DOI] [PubMed] [Google Scholar]
  23. Morrison J. C., Wiser W. L., Rosser S. I., Gayden J. O., Bucovaz E. T., Whybrew W. D., Fish S. A. Metabolites of meperidine related to fetal depression. Am J Obstet Gynecol. 1973 Apr 15;115(8):1132–1137. doi: 10.1016/0002-9378(73)90564-4. [DOI] [PubMed] [Google Scholar]
  24. Morselli P. L., Rovei V. Placental transfer of pethidine and norpethidine and their pharmacokinetics in the newborn. Eur J Clin Pharmacol. 1980 Jul;18(1):25–30. doi: 10.1007/BF00561475. [DOI] [PubMed] [Google Scholar]
  25. SHNIDER S. M., MOYA F. EFFECTS OF MEPERIDINE ON THE NEWBORN INFANT. Am J Obstet Gynecol. 1964 Aug 15;89:1009–1015. doi: 10.1016/0002-9378(64)90292-3. [DOI] [PubMed] [Google Scholar]
  26. Stambaugh J. E., Hemphill D. M., Wainer I. W., Schwartz I. A potentially toxic drug interaction between pethidine (meperidine) and phenobarbitone. Lancet. 1977 Feb 19;1(8008):398–399. doi: 10.1016/s0140-6736(77)92606-x. [DOI] [PubMed] [Google Scholar]
  27. Stambaugh J. E., Wainer I. W., Sanstead J. K., Hemphill D. M. The clinical pharmacology of meperidine--comparison of routes of administration. J Clin Pharmacol. 1976 May-Jun;16(5-6):245–256. doi: 10.1002/j.1552-4604.1976.tb02401.x. [DOI] [PubMed] [Google Scholar]
  28. Szeto H. H., Inturrisi C. E. Simultaneous determination of meperidine and normeperidine in biofluids. J Chromatogr. 1976 Oct;125(3):503–510. doi: 10.1016/s0021-9673(00)85713-1. [DOI] [PubMed] [Google Scholar]
  29. Szeto H. H., Zervoudakis I. A., Cederqvist L. L., Inturrisi C. E. Amniotic fluid transfer of meperidine from maternal plasma in early pregnancy. Obstet Gynecol. 1978 Jul;52(1):59–62. [PubMed] [Google Scholar]
  30. Tamsen A., Hartvig P., Dahlström B., Lindström B., Holmdahl M. H. Patient controlled analgesic therapy in the early postoperative period. Acta Anaesthesiol Scand. 1979 Oct;23(5):462–470. doi: 10.1111/j.1399-6576.1979.tb01475.x. [DOI] [PubMed] [Google Scholar]
  31. Turner S., Macfarlane A. Localisation of human speech by the newborn baby and the effects of pethidine ('meperidine'). Dev Med Child Neurol. 1978 Dec;20(6):727–734. doi: 10.1111/j.1469-8749.1978.tb15303.x. [DOI] [PubMed] [Google Scholar]
  32. Wiener P. C., Hogg M. I., Rosen M. Effects of naloxone on pethidine-induced neonatal depression. Part I--Intravenous naloxone. Br Med J. 1977 Jul 23;2(6081):228–229. doi: 10.1136/bmj.2.6081.228. [DOI] [PMC free article] [PubMed] [Google Scholar]

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