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Disposition of meperidine and normeperidine following multiple doses during labor

I. Mother
  • Betty R. Kuhnert
    Correspondence
    Reprint requests: Betty R. Kuhnert, Ph.D., Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital, 3395 Scranton Road, Cleveland, OH 44109.
    Affiliations
    Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA

    the Perinatal Clinical Research Center, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA.
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  • Elliot H. Philipson
    Affiliations
    Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA

    the Perinatal Clinical Research Center, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA.
    Search for articles by this author
  • Paul M. Kuhnert
    Affiliations
    Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA

    the Perinatal Clinical Research Center, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA.
    Search for articles by this author
  • Carol D. Syracuse
    Affiliations
    Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA

    the Perinatal Clinical Research Center, Cleveland Metropolitan General Hospital/Case Western Reserve University Cleveland, Ohio, USA.
    Search for articles by this author
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      Abstract

      Normeperidine, the active meperidine metabolite, has been implicated in adverse neonatal effects that may occur following administration of meperidine to parturients. However, recent studies have suggested that normeperidine levels are not high enough to have adverse effects following single low doses of meperidine. It is not clear what occurs following multiple injections. Therefore the purpose of this study was to quantitate plasma levels of meperidine and normeperidine in the mother following multiple doses of meperidine over long time periods and to determine the half-life of normeperidine. Twelve mothers who received multiple intravenous doses of meperidine were studied. The results show that both meperidine and normeperidine accumulate in matermal plasma following multiple injections and that the half-life of normeperidine averages 20.6 hours. The data suggest that maximum exposure of the fetus to both meperidine and normeperidine would result from multiple doses to the mother because of a continued diffusion gradient from mother to fetus.

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