Meperidine-induced seizure in a sickle cell patient using a patient-controlled analgesia pump.

Meperidine is indicated and frequently used for the relief of moderate to severe pain associated with various disease states and procedures, including sickle cell crisis pain, postoperative analgesia, and migraine headaches. Additionally, the parenteral form is approved for preoperative medication. The use of meperidine for analgesia should not be considered benign. Common adverse reactions caused by meperidine are similar to those found with other narcotic analgesics and include dizziness, sedation, nausea, vomiting, constipation, euphoria, dysphoria, and disorientation. The major hazards with meperidine use include respiratory tract depression, respiratory arrest, shock, and cardiac arrest. Several reports of seizure activity during meperidine therapy have been described. 1-8 This seizure activity is rarely experienced with other narcotic analgesic use. Most of these seizures have occurred in patients with underlying renal insufficiency; however, in four case reports there was documented meperidine-induced seizure activity in patients without renal disease. 5-8 Only one case involved a patient receiving meperidine by means of a patient-controlled analgesic pump.s Furthermore, in many of these case reports other causes of seizures were not ruled out. This case report re-emphasizes the potential for meperidine-induced seizures in patients who have normal renal function while receiving the drug through a patient-controlled analgesic pump. Although this patient did have sickle cell anemia, there was no history of any seizures or other neurological problems.