Comparison of Doses of the Epidural Buprenorphine for Postoperative Pain Control after Lower Abdominal Surgery

Kim, Hyun Soo; Lee, Choon Bong; Kim, Tae Seong; Kim, Kwang Min

Abstract

Since the first use of epidural morphine in man, a number of other opiates have been studied including fentanyl, pethidine, methadone, diamorphine and buprenorphine. Among them buprenorphine is a relatively new synthetic opiate that is known to be highly lipophilic and to have an affmity for the opiate receptor approximately twice that of morphin:, It is produced in a preservative free solution, and would seem a logical choice for epidural analgesia. But there was no data on the adequate dose for the. postoperative pain control after lower abdominal surgery. Current study was designed to investigate the efficacy of three doses of epidural buprenorphine for postoperative pain control with the checking the pain score. Fifty seven female patients undergoing elective lower abdominal surgery were randomly assigncd to receive epidural buprenorphine as a rate of 0.3 (group A, initial dose 0.15 mg + maintenance dose O.l5 mg), 0.45 (group B, 0.15 mg + 0.3 mg), or 0.6 mg (group C, 0.3 mg + 0.3 mg) utilizing the Two-Day TI4l Infusor during the two days after cessation of operation. Authors compared the efficacy of three doses with checking the pain scale (Facial expression pain scale, Prince Henry pain scale) at 6, 12, 24, and 48 hour postoperatively. Side-effects were recorded. There were no significant difference among three groups with respects to mean age. Analgesic effects for patients receiving 0.6 mg (group C) were superior to those of group A but were not significantly different from analgesic effects of group B except 6 hour postoperatively. Side-effects (nausea and vomiting) of group C were significantly more than group B. The dose of epidural buprenorphine in Group B (initial dose 0.15 mg+maintenance dose 0 3 mg) may be recommended for postoperative analgesia following lower abdominal surgery.