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Anesthetic Efficacy of Lidocaine/Meperidine for Inferior Alveolar Nerve Blocks
Amanda GoodmanDDS, MS,
Al ReaderDDS, MS,
John NussteinDDS, MS,
Mike BeckDDS, MA, and
Joel WeaverDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 53: Issue 4
Online Publication Date: Jan 01, 2006
DOI: 10.2344/0003-3006(2006)53[131:AEOMFI]2.0.CO;2
Page Range: 131 – 139

. Meperidine was first introduced in 1939 as an analgesic, sedative, and antispasmodic agent. 21 It is also known as pethidine or Demerol. Meperidine is a phenylpiperidine derivative of the opioids. 22 23 The molecular weight and pKa of meperidine are closer to lidocaine than other opioids. 22 Clinically, meperidine has local anesthetic activity. A number of clinical and experimental studies 24–36 have shown that meperidine induces spinal anesthesia and blocks action potentials, providing segmental and sensory blocks comparable to those provided by lidocaine. In

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Anesthetic Efficacy of Meperidine in Teeth With Symptomatic Irreversible Pulpitis
Ladan MohajeriDDS, MS,
Farnaz SalehiDDS,
Payman MehrvarzfarDDS, MS,
Hamide ArfaeeDDS,
Behnam BohluliDDS, MS, and
Reza HamedyDDS
Article Category: Other
Volume/Issue: Volume 62: Issue 1
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.1.14
Page Range: 14 – 19

compared different anesthetic agents 13 or their concentrations 14 to improve their efficacy. Activating the opioid receptors peripherally in inflammatory conditions has become a new trend in research to manage postoperative pain. 15 Synergy between local anesthetics and opioids has become an interesting field of research recently. 16 Opioids are frequently added to local anesthetics in a variety of surgical procedures, eg, intrathecal application for minor surgery. 17 Meperidine or its derivatives, eg, pethidine (meperidine chloride) or norpethidine

Efficacy of Midazolam/Meperidine vs Midazolam/Hydromorphone for Enteral Moderate Sedation in the Pediatric Dental Patient
Bryce W. KinardDMD,
Andrew S. ZaleDMD, MSD, and
Kenneth L. ReedDMD
Article Category: Research Article
Volume/Issue: Volume 71: Issue 1
Online Publication Date: May 03, 2024
DOI: 10.2344/22-00037
Page Range: 15 – 18

(nitrous oxide/oxygen), is used to achieve moderate levels of sedation during dental procedures. 3 Midazolam is one of the most used medications for enteral sedation in the pediatric dental field. However, its working time is limited, and it notably lacks any analgesic properties. 4 The addition of opioids such as meperidine has been used to overcome these deficiencies. 5 Recently, the use of meperidine has diminished due to its active metabolite, normeperidine, and negative side effects such as altered mental status, nervousness, myoclonus, seizures, delirium, and

Figure 2.; Incidence of second molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 2.
Figure 2.

Incidence of second molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

Figure 3.; Incidence of first molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 3.
Figure 3.

Incidence of first molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

Figure 4.; Incidence of second premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 4.
Figure 4.

Incidence of second premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

Figure 5.; Incidence of first premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 5.
Figure 5.

Incidence of first premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

Figure 6.; Incidence of lateral incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 6.
Figure 6.

Incidence of lateral incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

Figure 7.; Incidence of central incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Amanda Goodman,
Al Reader,
John Nusstein,
Mike Beck, and
Joel Weaver
Figure 7.
Figure 7.

Incidence of central incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).

A Prospective Study of 2 Sedation Regimens in Children: Chloral Hydrate, Meperidine, and Hydroxyzine Versus Midazolam, Meperidine, and Hydroxyzine
Marianne M. SheroanDMD, MS, MS,
Diane C. DilleyDDS,
Warner J. LucasDDS, MD, and
William F. VannDMD, PhD
Article Category: Research Article
Volume/Issue: Volume 53: Issue 3
Online Publication Date: Jan 01, 2006
DOI: 10.2344/0003-3006(2006)53[83:APSOSR]2.0.CO;2
Page Range: 83 – 90

), meperidine (M), and hydroxyzine (H). Hasty et al 7 reported excellent behavioral outcomes with this regimen and found this combination to be safe as assessed by pulse oximetery and capnography. A more recent and comprehensive retrospective review of 195 pediatric conscious sedations with the CH/M/H cocktail reported that 72% of the sedations were satisfactory and that adverse outcomes were few and minor under a strict protocol and use of oxygen supplementation. 8 In one retrospective study, 9 an 84% success rate was found when the regimen CH/M/H was used with N 2 O