Does pethidine still have a place in therapy?

Abstract

In chronic pain management, the general consensus at present is that pethidine has no role to play. There is a myriad of other options including spinal implants, longacting opioid preparations for nociceptive pain or the newer drugs for neuropathic pain. In all cases ruling out new or undiagnosed pathology and early consideration of the role of psychosocial factors is important. Pethidine can be used to treat acute pain for a short time. After this time other options should be considered due to the risk of accumulation of norpethidine and the potential adverse sequelae. If pethidine is used in episodes of recurrent pain such as migraine, patients can become overly reliant on this medication. The resultant drug-seeking behaviour can be very difficult to treat.