Name of the Procedure:

Injection, meperidine and promethazine HCl, up to 50 mg

• Common Names: Demerol Injection, Mepergan Injection
• Technical/Medical Term: Meperidine and Promethazine Hydrochloride Injection (HCPCS Code: J2180)

Summary

This procedure involves the injection of meperidine, a pain reliever, and promethazine, an antihistamine with sedative properties. It is commonly used to manage moderate to severe pain and prevent nausea and vomiting.

Purpose

The procedure is used to:

• Alleviate moderate to severe pain.
• Prevent and control nausea and vomiting often associated with surgery, chemotherapy, or severe illnesses.

Indications

• Severe pain not controlled by other pain relief methods.
• Nausea and vomiting that have not responded to other treatments.
• Situations where both analgesic and antiemetic effects are needed.

Preparation

• Patients may need to fast for a few hours before the injection.
• Inform your healthcare provider of any allergies, existing medications, and health conditions.
• Diagnostic tests, such as blood work, may be required to assess overall health before the procedure.

Procedure Description

1. The patient is positioned comfortably, typically lying down.
2. The injection site (usually in the muscle or under the skin) is cleaned with an antiseptic solution.
3. A healthcare professional administers the injection using a syringe and needle.
4. Meperidine provides pain relief, while promethazine acts as a sedative and antiemetic.
5. The patient is monitored for a brief period post-injection to ensure no adverse reactions.

Tools and Equipment: Syringe, needle, antiseptic solution
Anesthesia/Sedation: Not typically required beyond the sedation effect of the medication itself

Duration

The injection process usually takes about 5 to 10 minutes. Monitoring time post-injection can vary.

Setting

• Hospital
• Outpatient clinic
• Surgical center

Personnel

• Healthcare professionals such as nurses or doctors administer the injection.
• Medical assistants may assist with preparation and monitoring.

Risks and Complications

Common risks include:

• Drowsiness
• Dizziness
• Dry mouth
• Constipation

Rare complications:

• Severe allergic reactions
• Respiratory depression
• Low blood pressure

Benefits

• Rapid relief from moderate to severe pain.
• Reduction in nausea and vomiting.
• Enhanced comfort, especially in post-operative settings. Benefits are usually realized within minutes to an hour after the injection.

Recovery

• Patients might be observed for a short time after the injection.
• Avoid driving or operating machinery for at least 24 hours.
• Follow-up with healthcare provider as advised; additional doses may be required based on pain and nausea control needs.

Alternatives

• Oral pain medications and antiemetics (e.g., pills or tablets).
• Intravenous (IV) pain relief methods.
• Non-pharmacological pain relief methods like physical therapy or acupuncture.

Pros and Cons of Alternatives:

• Oral medications are less invasive but might have a slower onset.
• IV methods provide similar benefits but require more specialized settings and might be more costly.
• Non-pharmacological methods are non-invasive but may not provide immediate relief.

Patient Experience

• During the procedure: slight discomfort from the injection site.
• After the procedure: relief from pain and nausea is often rapid; may experience sedation or drowsiness. Pain Management and Comfort: Any discomfort can usually be managed with mild analgesics and resting in a comfortable environment.