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December 16, 1974

Meperidine vs Morphine

Author Affiliations

Brooklyn, NY

JAMA. 1974;230(11):1512. doi:10.1001/jama.1974.03240110016005

To the Editor.—  The statement by Alderman (229:1647, 1974) that "meperidine hydrochloride in parenterally administered doses of 75 mg provides effective analgesia of the same duration as does 10 mg of morphine sulphate" is counter to that of standard texts and journals of pharmacology1-3 and is not consistent with our own experience.While it is accepted that the meperidine dose equivalent to 10 mg of morphine is 75 to 100 mg, duration of analgesia by meperidine may be as little as 50% that of morphine. This may not be observed when the pain of myocardial anoxia is fully or partially relieved during the first or second administration of analgesic, but in chronic or sustained pain, such as occurs in malignant invasion of bones or in sickle cell crisis, the difference is readily apparent to the alert physician and nurse.It has been suggested that physicians are undertreating patients in pain.