Post-operative intravenous continuous analgesia: comparison of buprenorphine, fentanyl and nalbuphine

Lejus, C.; Blanlœil, Y.; François, T.; Testa, Sophie; Michel, Patrick; Dixneuf, B

doi:10.1097/00003643-199601000-00011

Cited by 6 publications

(1 citation statement)

References 27 publications

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“…Although most of these side effects are mild in nature and have little clinical relevance, respiratory depression is a potentially life-threatening complication of opiate therapy ( 3 , 4 ). Therefore, careful titration of the opioid dose to the desired analgesic effect is essential to avoid respiratory depression ( 5 ). This applies particularly to potent opioid analgesics.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic–Pharmacodynamic Modeling of the Effectiveness and Safety of Buprenorphine and Fentanyl in Rats

et al. 2007

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Objective. Respiratory depression is a serious and potentially life-threatening side-effect of opioid therapy. The objective of this investigation was to characterize the relationship between buprenorphine or fentanyl exposure and the effectiveness and safety outcome in rats. Methods. Data on the time course of the antinociceptive and respiratory depressant effect were analyzed on the basis of population logistic regression PK-PD models using non-linear mixed effects modeling software (NONMEM). The pharmacokinetics of buprenorphine and fentanyl were described by a threeand two-compartment model, respectively. A logistic regression model (linear logit model) was used to characterize the relationship between drug exposure and the binary effectiveness and safety outcome. Results. For buprenorphine, the odds ratios (OR) were 28.5 (95% CI, 6.9-50.1) and 2.10 (95% CI, 0.71-3.49) for the antinociceptive and respiratory depressant effect, respectively. For fentanyl these odds ratios were 3.03 (95% CI, 1.87-4.21) and 2.54 (95% CI, 1.26-3.82), respectively. Conclusion. The calculated safety index (OR antinociception /OR respiratory depression ) for fentanyl of 1.20 suggests that fentanyl has a low safety margin, implicating that fentanyl needs to be titrated with caution. For buprenorphine the safety index is 13.54 suggesting that buprenorphine is a relatively safe opioid.

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Section: Introductionmentioning

confidence: 99%