Comparison of anileridine and meperidine as obstetric analgesia

Anileridine, a relative newcomer to the field of obstetric analgesia, was compared with meperidine in a double blind study involving four treatment groups. These treatment groups were as nearly alike in size and make-up as it is possible to obtain with a random sampling of patients. Four hundred seventy-one women were given a primary injection of either 75 mg. meperidine (Group 1), 30 mg. anileridine (Group 2), 75 mg. meperidine with 5 mg. perphenazine (Group 3), or 30 mg. anileridine with 5 mg. perphenazine (Group 4). All four of the treatment groups received 0.4 mg. of atropine sulfate and 0.5 mg. levallorphan tartrate. The state of anxiety of each woman was noted on admission and an evaluation of combined sedative-analgesic effect was made following the primary injection of medication. The patient's behavior in the postmedication period was noted, and the infants were rated by Apgar scores at 1 and 5 minutes after delivery. The analgesics produced almost exactly comparable effects, with 30 mg. anileridine apparently being equivalent to 75 mg. meperidine. When a phenothiazine derivative was added to either analgesic, an increase in the optimum response was obtained among the apprehensive patients but not in the calm patient. This increase was not statistically significant. Apgar ratings were essentially the same in all four treatment groups and indicated that anileridine, in equivalent dosage, had no more depressant effect on the fetus than meperidine whether or not these drugs were combined with the phenothiazine derivative. No significant side effects were noted following the use of either analgesic agent.