ST. LOUIS -- A federal appeals court ruled Monday that the state's lethal injection procedure is not cruel and unusual punishment, a decision that could restart executions in the state for the first time in nearly two years.

The case filed on behalf of condemned killer Michael Taylor prompted a federal judge last year to place a moratorium on Missouri executions. U.S. District Judge Fernando Gaitan Jr. said he wanted to be sure that the three-drug injection method did not cause risk of pain and suffering.

The ruling by a three-judge panel of the 8th U.S. Circuit Court of Appeals reversed Gaitan's ruling.

"Mr. Taylor presents no argument that the penalty of death by lethal injection is grossly out of proportion to the severity of his crime," the appeals court wrote.

Gov. Matt Blunt said he is directing the Department of Corrections to prepare execution procedures in compliance with the ruling.

"One of the most important jobs I have as governor is to help keep Missourians safe," Blunt said. "Capital punishment is a vital deterrent to the most serious of crimes."

And Attorney General Jay Nixon said the decision "reopens the necessary legal avenue for the state of Missouri to move forward on this issue."

Ginger Anders, Taylor's attorney, said she would appeal but declined further comment.

But Margaret Phillips of the Eastern Missouri Coalition Against the Death Penalty said many questions remain unanswered and it would be unwise for the state to renew executions.

"The uncertainty of all of this is a good indication that Missouri needs a moratorium on the death penalty," she said.

Richard Dieter, executive director of the Death Penalty Information Center in Washington, said the ruling is significant but is unlikely to lead to a flood of new executions around the country. Thirty-eight states execute prisoners, all but one by lethal injection; Nebraska uses electrocution.

"Certainly all states that have lethal injection are watching what happens because the Missouri case is furthest along in litigation," Dieter said. "But in each state there are special things that make each one a little different."

Gaitan wanted the state to involve a doctor specializing in anesthesia, but the state has been unable to find such a doctor willing to participate in the executions.

Missouri is among at least nine states that have put executions on hold as it grapples with whether lethal injection is inhumane.

The debate centers on how three drugs are administered in succession. If the initial anesthetic does not take hold, a third drug that stops a condemned prisoner's heart can cause excruciating pain, it has been argued. But the inmate would not be able to communicate the pain because of a second drug that paralyzes him.

But in its ruling, the court stated, "The protocol is designed to ensure a quick, indeed a painless, death, and thus there is no need for the continuing careful, watchful eye of an anesthesiologist or one trained in anesthesiology, whose responsibility in a hospital's surgery suite (as opposed to an execution chamber) is to ensure that the patient will wake up at the end of the procedure."

Other states are dealing with similar issues.

In Ohio, death penalty opponents last month called on the state to halt executions after prison staff struggled to find a suitable vein on a condemned man's arm to deliver the lethal chemicals. The execution team stuck Christopher Newton at least 10 times with needles to insert the shunts where the chemicals are injected.

But the Missouri ruling did not address accidents or mistakes by staff, only whether the state protocol was sufficient to guarantee against the likelihood of undue suffering by the inmate.

The last execution in Missouri occurred on Oct. 26, 2005, when convicted killer Marlin Gray was put to death. He was the 67th man executed since Missouri renewed the death penalty in 1989.

Taylor and Roderick Nunley were convicted of killing 15-year-old Ann Harrison in Kansas City in 1989 after kidnapping her from a school bus stop. Nunley is also among the 47 men on Missouri's death row.

Taylor was hours away from being executed in February 2006 when the procedure was halted.

The debate over executions increased last year after it was learned that Missouri's doctor responsible for overseeing administration of the lethal chemicals, identified as surgeon Alan Doerhoff of Jefferson City, was dyslexic. Anders has called relying on the dyslexic doctor for the process a "set-up for disaster."

Doerhoff testified last year that he'd overseen Missouri's executions for years, and on occasion he altered the amount of anesthetic given to inmates.

Anders was not arguing that Taylor's life be spared, although his family is hanging on to that hope.