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Meptazinol and morphine in postoperative pain assessed with a new method for onset and duration
C Siegel1, A Sunshine, H Richman
1Department of Surgery, New York Infirmary-Beekman Downtown Hospital, New York, NY.
Abstract:
Meptazinol, m-(3-ethyl-1-methyl-hexahydro-1-H-azepin-3-yl) phenol hydrochloride is a centrally active opioid analgesic with a specificity for the mu-1 receptor. It has been reported to lack many of the side effects commonly observed with morphine and morphinelike drugs in man. The objective of this study was to assess the analgesic efficacy and safety of meptazinol (50 mg and 100 mg) relative to morphine (5 mg and 10 mg) when administered intramuscularly for the treatment of postoperative pain. In addition, a new clinical method for measuring onset and duration and a statistical technique for evaluating the study data are presented. One hundred and seventeen patients were evaluated for 6 hours in a randomized double blind, single dose, parallel-groups trial. Estimates of relative potency for hourly pain and relief parameters, and the summary variables sum of pain intensity differences (SPID) and total pain relief (TOTPAR) were performed. The estimate of relative potency of meptazinol to morphine for pain relief was 0.19 at 1/2 hour (i.e. 100 mg of meptazinol was approximately equivalent to 20 mg of morphine). Thereafter, there was a rapid decline of efficacy for meptazinol, with a relative potency estimate of 0.12 at 1 hour and 0.06 at 2 hours. The distribution functions for several time related events were estimated including time to onset, duration and time to remedication. The two drugs had approximately equal onset, but meptazinol had significantly shorter duration. More patients on meptazinol required remedication with a rescue analgesic and at an earlier time than patients on morphine.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Meptazinol showed less effective pain relief than morphine for postoperative pain, with a shorter duration and earlier need for additional analgesia. This study compared meptazinol and morphine efficacy and safety.
Area of Science:
- Pharmacology
- Pain Management
- Clinical Trials
Background:
- Meptazinol is a centrally acting opioid analgesic targeting mu-1 receptors.
- It is noted for potentially fewer side effects compared to morphine.
- Postoperative pain management requires effective and safe analgesic options.
Purpose of the Study:
- To compare the analgesic efficacy and safety of meptazinol versus morphine for postoperative pain.
- To evaluate meptazinol (50 mg and 100 mg) against morphine (5 mg and 10 mg) via intramuscular administration.
- To introduce novel methods for measuring analgesic onset, duration, and data analysis.
Main Methods:
- A randomized, double-blind, single-dose, parallel-groups trial involving 117 patients.
- Intramuscular administration of meptazinol or morphine for postoperative pain.
- Assessment of pain relief and analgesic efficacy over a 6-hour period using various parameters and statistical techniques.
Main Results:
- Meptazinol's relative potency to morphine for pain relief was initially 0.19 (100 mg meptazinol ≈ 20 mg morphine) at 0.5 hours, declining rapidly thereafter.
- Onset of analgesia was similar for both drugs, but meptazinol had a significantly shorter duration of action.
- Patients receiving meptazinol required rescue analgesia sooner and more frequently than those on morphine.
Conclusions:
- Meptazinol demonstrates significantly less sustained analgesic efficacy compared to morphine for postoperative pain.
- While onset is comparable, the shorter duration and increased need for rescue medication limit meptazinol's utility.
- Morphine provided more effective and longer-lasting pain relief in this postoperative setting.