Meperidine-related seizures associated with patient-controlled analgesia pumps

To report three cases of meperidine-related seizures when meperidine was administered via patient-controlled analgesia pump (PCAP) and to review literature related to meperidine-associated seizures.

Case reports and review articles identified by a computerized search (MEDLINE) and manual search (Index Medicus).

PCAPs are being used frequently to relieve the pain of sickle cell crisis as well as pain from many other etiologies. We report three cases of meperidine-related seizures associated with its administration via PCAP. Each of the patients received either relatively high doses, long-term therapy, or both. Meperidine has been associated with seizure activity when administered via traditional routes. Previously identified risk factors for the development of meperidine-related seizures include renal failure, high meperidine dosages, and coadministration of hepatic enzyme-inducing medications or phenothiazines.

Meperidine administered via PCAP may be associated with seizures. Optimally, an alternative analgesic should be administered when this route is used.