What narcotic agent is not approved for repeated Patient Controlled Analgesia (PCA) pump usage?

Meperidine, also known as Demerol, is not approved for repeated Patient Controlled Analgesia (PCA) pump usage due to its unique pharmacological properties and side effects. Unlike other opioids used in PCA, meperidine has a metabolite, normeperidine, which can accumulate in the body with repeated dosing. This accumulation can lead to neurological side effects such as seizures, especially in patients with impaired renal function or those receiving prolonged therapy.

Fentanyl, morphine, and hydromorphone, by contrast, do not pose the same risks of accumulation and are considered safer options when it comes to repetitive administration through PCA systems. They are utilized for effective pain management without the concerning adverse effects associated with meperidine.