Pethidine--does familiarity or evidence perpetuate its use?

A review of the current literature shows pethidine (meperidine) use to be less favourable than commonly thought. When first synthesised in the 1930s, it was prematurely lauded as a substitute for morphine, and marketed as a drug lacking many of the adverse effects such as respiratory depression, urinary retention, constipation and chemical dependency typical of opioids such as morphine. None of these claims has been substantiated by clinical evidence; in fact pethidine carries additional risks that ensure its declining use internationally. These risks, and the evidence questioning its analgesic efficacy, make it necessary to review its continued popular use in South Africa.