<p>Hypersensitivity to Pethidine.<br />
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Respiratory depression, or where respiratory reserve is depleted (acute bronchial asthma, chronic airway disease, severe emphysema, severe chronic bronchitis, kyphoscoliosis).<br />
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Head injury, raised intracranial pressure (apart form introducing monitoring and diagnostic problems, hypercapnia associated with respiratory depression can itself result in elevated intracranial pressure), brain tumour.<br />
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Cardiac arrythmias, especially supraventricular tachycardias, cor pulmonale. Pethidine has a vagolytic action and may produce a significant increase in the ventricular response rate.<br />
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Concurrent use of monoamine oxidase inhibitors (MAOI&rsquo;s), including selegeline, or use of MAOI&rsquo;s within two weeks prior. The combination of monoamine oxidase inhibitors and pethidine has caused hypotension, hypertension, excitation, rigidity, hyperpyrexia and/or convulsions and in some cases fatalities have been reported. This combination should be avoided.<br />
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Pre-eclampsia, eclampsia.<br />
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Convulsive states such as status epilepticus, tetanus and strychnine poisoning, due to the stimulatory effects of pethidine on the spinal cord.<br />
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Diabetic acidosis where there is a danger of coma.<br />
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Acute alcoholism or delirium tremens.<br />
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Severe liver disease, incipient hepatic encephalopathy.<br />
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Patients with a low platelet count, coagulation disorders or receiving anticoagulant treatment.<br />
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<strong>Continuous Intravenous Infusion</strong>: The administration of pethidine via continuous intravenous infusion in patients with renal impairment is contraindicated.<br />
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<strong>Patient-Controlled Analgesia</strong>: The administration of pethidine via patient-controlled analgesia (PCA) in young children and adults with poor cognitive function is contraindicated. The administration of pethidine via PCA in patients with renal impairment is contraindicated.</p>