In order to control pain during the early postoperative period, patient-controlled analgesia (PCA) with buprenorphine as an analgesic drug was applied in 23 patients undergoing abdominal operations. With this "on demand" system, the patient was allowed to self administer narcotic analgesic medication using a programmable infusion pump. Overdose could be minimized with a mandatory lock-out interval between allowable injections. Average total requirement of buprenorphine was 0.355 mg at 48 hr after operation. Nineteen of the 23 (82.6%) patients characterized their pain control as "excellent" or "good". In these patients there existed high correlation between the total number of patient attempts and the number of successful injections. The PCA system was thought to provide improved pain relief at smaller total drug dosages. In addition, earlier and greater spontaneous physical activity was maintained with PCA therapy. The potential for overdose could be minimized, and thereby PCA appears to be an efficacious and safe method of providing for postoperative pain relief, patient-controlled analgesia ; postoperative pain ; buprenorphine ; abdominal surgery Patient, controlled analgesia (PCA) allows patients to self-administer small doses of analgesic medications as necessary to control postoperative pain. Although the concept of PCA therapy is not new (Forrest et al. 1970; KeeriSzanto 1971;Sechzer 1971), recent progress in the area of infusion pump technology has renewed interest in this concept. PCA equipment consists of an infusion pump electronically connected to a timing device. The patient triggers the device by depressing a thumb button conveniently located on a cord extending from the machine.The objective of this study was to evaluate the efficacy of the Bard Harvard PCA system (White 1985) using buprenorphine as an analgesic drug for providing postoperative pain relief.

The sulfokinase, that transfers activated sulfate from PAPS (3'-phosphoadenosine-5'-phosphosulfate) to nitrocatechol sulfate was studied. 1. It is thought that the enzyme plays an important role in detoxication by the sulfation of polyhydric phenols in liver. 2. The enzyme had an optimum at pH 8.0 in Tris-acetate buffer. Km was 0.105 x 10(-3)M. The rate of conjugation was linear within 1 min. 3. The main distribution of the sulfokinase was found in the liver, lungs, spleen and various other organs in the rat. The activity of the enzyme in rat liver was the highest in soluble fraction. In chronic hepatic injury caused by carbon tetrachloride injection, the activity of the enzyme gradually decreased to below about one half of the control value.

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Acute and chronic liver damage was caused by the administration of either galactosamine or carbon tetrachloride. Consequently, the rats with damaged livers were killed after vitamin E was administered. The livers were removed and were homogenated. Indicator enzymes (5'-nucleotidase, arylsulfatase, cytochrome C oxidase and glucose-6-phosphatase) of organella membranes were measured in the homogenates of the normal and damaged livers. The effects of vitamin E resulted in the stabilizing of the impaired membranes of plasma, lysosome, mitochondria and microsome; (1) the abnormal decrease of 5'-nucleotidase activity and glucose-6-phosphatase activity, and the abnormal increase of arylsulfatase activity, which induced galactosamine or carbon tetrachloride, and (2) the abnormal decrease of cytochrome C oxidase activity induced by galactosamine- HCl, were normalized.