Double‐blind, Multiple‐dose Comparison of Buprenorphine and Morphine in Postoperative Pain

Abstract

The analgesic profile and side-effects of buprenorphine 0.3 mg and morphine 10 mg intramuscularly were compared postoperatively in a double-blind, non-crossover, multiple-dose study. When the patient complained of moderate to severe postoperative pain after halothane-relaxant anesthesia for upper abdominal surgery, the first test dose of either drug was given. Subsequent similar doses of buprenorphine 0.3 mg or morphine 10 mg were given when required (maximum ten doses). The first dose of both drugs gave an equal decrease in pain intensity, suggesting a relative potency of 33:1 for both buprenorphine/morphine. A mean of 0.51 mg buprenorphine or 17 mg morphine had to be administered for satisfactory initial analgesia. Thereafter, the next analgesic dose was required a mean of 10.3 h after buprenorphine compared to 5.9 h after morphine (P less than 0.01). Significantly (P less than 0.01) fewer analgesic doses (mean 5.6) were needed in the buprenorphine group within the first 48 h postoperatively as compared to the morphine group (mean 7.3). A more pronounced mean decrease in the respiratory rate was observed after buprenorphine, but the mean minimum respiratory rates did not differ significantly from each other. Other effects of the two drugs on vital signs were similar. The incidence of other side-effects was fairly similar after both analgesics. The patients' subjective appraisal favoured buprenorphine.

A comparative study of intramuscular buprenorphine and morphine in the treatment of chronic pain of malignant origin.

“…Our data confirm those of other studies where buprenorphine and morphine have been compared in patients with pain of non-malignant origin (Downing et al, 1977;Harcus et al, 1979;Hayes et al, 1979;Hovell, 1977;Hovell & Ward, 1977;Kamel & Geddes, 1978;Kay, 1978;Tigerstedt & Tammisto, 1980). As such, buprenorphine seems to be an effective analgesic in cancer pain, the main advantage being the long duration of action resulting in fewer injections per day.…”

“…Buprenorphine is a newly developed derivative of the opium alkaloid thebaine acting as an agonistantagonist on the opiate receptor system. It has undergone rather extensive clinical testing as an analgesic in postoperative pain (Downing et al, 1977;Harcus et al, 1979;Hovell, 1977;Hovell & Ward, 1977;Kamel & Geddes, 1978;Kay, 1978;Tigerstedt & Tammisto, 1980), and for chest pain in patients with suspected myocardial infarction (Hayes et al, 1979). Only limited information exists as to the effect of buprenorphine in cancer pain.…”

Failure of transcutaneous electrical nerve stimulation and indomethacin to reduce opiate requirement following cholecystectomy

“…Oxycodone, a widely used opiate for postoperative analgesia in Finland corresponds to morphine in its analgesic action (30). Buprenorphine has a longer duration of action than morphine (31)(32)(33)(34)(35)(36). In our study the overall consumption of buprenorphine (i.e.…”

Peridurale Analgesie mit Buprenorphin und Morphin bei postoperativen Schmerzen

“…Diese Ergebnisse stützen die Annahme von McQuay, der bei Frauen einen deutlich geringeren postoperativen Analgetikabedarf fand als bei Männern (18 20). Will man die beschriebenen Nebenwirkungen auf das peridurale Morphin zurückführen, so ergibt sich eine Häufigkeit von 17 %, die damit erheblich niedriger liegt als nach systemischer Opiat-Applikation (7, 11,14,15,24). Dodson beschreibt bei 56 % der Patienten, die Morphin intravenös erhielten, eine Obelkeit, bei 8 % Erbrechen und bei 55 % Schläfrigkeit (7).…”