buprenorphine and Esophageal-Neoplasms

Pain during dilatation of radiation strictures is a troublesome complaint. There is little information on sedation and analgesia during this procedure. We performed a pilot study to compare the analgesic efficacy of sublingual buprenorphine and intravenous pentazocine during dilatation of radiation-induced esophageal strictures.. Thirty-one patients with esophageal cancer who had radiation-induced strictures were randomized to receive either buprenorphine 0.2 mg sublingually two hours before dilatation (n = 17) or pentazocine 30 mg intravenously five minutes before dilatation (n = 14). Dilatation was considered successful if it could be performed to 12 mm diameter or more. Pain experienced during dilatation was graded as mild, moderate or severe.. Sixteen patients in the buprenorphine group and 12 in the pentazocine group were dilated to > 12 mm size (p = ns). Twelve and nine patients respectively in the two groups experienced mild or no pain; ten and six patients had minor side-effects (p = ns).. Buprenorphine is useful for sedoanalgesia during dilatation of radiation-induced strictures of the esophagus.

Topics: Administration, Sublingual; Adult; Aged; Analgesics, Opioid; Anesthesia, Local; Buprenorphine; Catheterization; Esophageal Neoplasms; Esophageal Stenosis; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pentazocine; Pilot Projects; Prospective Studies; Radiation Injuries; Treatment Outcome

Topics: Aged; Analgesics, Opioid; Buprenorphine; Double-Blind Method; Esophageal Neoplasms; Esophagus; Female; Hemodynamics; Humans; Injections, Intramuscular; Male; Middle Aged; Morphine; Pain, Postoperative; Pentazocine; Randomized Controlled Trials as Topic

A 48-year-old man who had undergone thoracotomy for carcinoma of the middle third of his oesophagus developed severe postoperative respiratory depression following intramuscular ketorolac 30 mg 2 h after 150 micrograms epidural buprenorphine. Summation of analgesia by drugs used in combination can have deleterious respiratory effects.

Topics: Analgesia, Epidural; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Buprenorphine; Depression, Chemical; Drug Interactions; Esophageal Neoplasms; Esophagectomy; Humans; Injections, Intramuscular; Ketorolac; Male; Middle Aged; Pain, Postoperative; Respiratory Insufficiency; Tolmetin

Topics: Administration, Sublingual; Aged; Buprenorphine; Esophageal Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Pain, Intractable