buprenorphine and Genital-Diseases--Female

Perioperative effects of buprenorphine during and after combined anesthesia for gynecological laparotomies were compared to those of morphine. In a controlled, randomized study two similar groups of patients received flunitrazepam (0.016 mg/kg) and either buprenorphine (0.008 mg/kg) or morphine (0.333 mg/kg); all patients were ventilated with a N2O/O2-mixture. To maintain adequate anesthesia, additional injections of buprenorphine or morphine and a volatile anesthetic agent (enflurane, less than 1.0 vol.%) were administered as needed. In some patients in both groups the injection of thiopental (1-2 mg/kg) became necessary for induction of anesthesia. Hemodynamic parameters showed a slight but not significant increase during intubation and remained stable intraoperatively (Figs. 1 and 2). The frequencies of additional intraoperative injections of buprenorphine or morphine and modalities of enflurane administration were similar in both groups. Based on an awakeness score, recovery from anesthesia was similar in both groups (Fig. 3). All patients were pain-free for a long period postoperatively (pain score 1-2, duration 6-10 h) (Fig. 4). In both groups respiratory depression could be demonstrated by means of ventilatory CO2 response (Figs. 6 and 7). The respiratory depression was of no clinical importance and seems to have been due to the combination of a long-acting benzodiazepine with an opiate. There were no differences in the occurrence of nausea and vomiting in both groups. Buprenorphine seems to be an alternative to morphine in combined anesthesia.

Topics: Acid-Base Equilibrium; Adult; Anesthesia, Endotracheal; Anesthesia, General; Anesthesia, Intravenous; Buprenorphine; Clinical Trials as Topic; Female; Genital Diseases, Female; Hemodynamics; Humans; Morphine; Pain, Postoperative; Random Allocation

In this comparative study in 102 female patients, midazolam or thiopentone was used as the sleep-inducing component in combination anaesthesia. During anaesthesia, three different analgesics: fentanyl, oxycodone and buprenorphine were tested. The sleep-inducing effect of midazolam was clearly slower in onset than that of thiopentone, but in other respects midazolam was a satisfactory inducing agent for general anaesthesia. Patients receiving midazolam and/or buprenorphine needed an additional dose of muscle relaxant less often than those receiving thiopentone and fentanyl or oxycodone. Buprenorphine produced a long postoperative analgesia lasting up to 10 hours, but these patients were also postoperatively drowsier, which gave a lower postanesthetic recovery score.

Topics: Adult; Anesthesia, General; Benzodiazepines; Buprenorphine; Female; Fentanyl; Genital Diseases, Female; Humans; Midazolam; Middle Aged; Morphinans; Oxycodone; Preanesthetic Medication

Topics: Adult; Buprenorphine; Clinical Trials as Topic; Female; Genital Diseases, Female; Humans; Meperidine; Morphinans; Morphine; Pain, Postoperative

The analgesic effect of sublingual buprenorphine 0.4 mg has been compared with pethidine 1 mg/kg given intramuscularly in 80 patients following major gynecologic operation. The results indicate a slower onset of action for sublingual buprenorphine in the first two hours (p less than 0.001), but it has a much longer duration and is more effective for pain relief (p less than 0.001) than pethidine. The main side-effects were nausea and vomiting which occurred after both treatments but with no significant difference.

Topics: Administration, Sublingual; Adult; Buprenorphine; Female; Genital Diseases, Female; Humans; Injections, Intramuscular; Meperidine; Middle Aged; Pain, Postoperative