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Dr. Waleed Hammadi Idan*


Pain is a major medical problem. The physiological and psychological consequences of acute and chronic pain are well-recognized. Inadequately treated pain can lead to detrimental physiological consequences and may also have psychological, economic, and social adverse effects. Effective pain control is desirable on humanitarian grounds, as well as for its potential to improve patients’ recovery, rehabilitation, and outcome. Acute pain can also increase heart rate and blood pressure, suppress immune functioning, and reduce pulmonary function, leading to an increased risk of dangerous complications, including myocardial ischemia, deep vein thrombosis, pulmonary embolism, hypoxia, pneumonia, and stroke. Current treatment options for the management of acute pain in the emergency department (ED) encompass opioid analgesics such as morphine, hydromorphone, or fentanyl and non-opioid analgesics such as acetaminophen, ketamine, local anesthetics, and non-steroidal anti-inflammatory drugs. Opioids have been utilized for thousands of years to treat pain and still continue to be one of the most commonly prescribed medications for acute pain management in the ED. Morphine is the standard opium-based analgesic with well-known analgesic effects and side effects. Meperidine (pethidine) is another opioid, but the use of meperidine is not very popular in countries such as the USA and Canada, however it is still used in Iran for pain management in the ED. In our country, Iran, the only opioids that can be parenterally used in the ED for acute pain management are meperidine, morphine, and fentanyl. There are few studies that have compared the analgesic effects of meperidine and morphine in non-opioid-dependent patients.[9] However, thus far no study has been conducted to compare the effectiveness and the side effects of morphine and meperidine for acute pain management in the opioid dependent patients. The present study was designed to clarify this issue.

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