Jakobs R, Adamek M U, von Bubnoff A C, Riemann J F
Dept of Medicine C, Klinikum der Stadt Ludwigshafen GmbH, Academic Teaching Hospital of the University of Mainz, Germany.
Scand J Gastroenterol. 2000 Dec;35(12):1319-23. doi: 10.1080/003655200453692.
To assess the analgesic efficacy and side effects of buprenorphine and procaine in patients with acute pancreatitis.
Forty patients (average age, 50 years; 23 male) with acute pancreatitis or an acute bout of a chronic pancreatitis were prospectively randomized to receive buprenorphine or procaine for pain relief. Both analgesics were administered as constant intravenous (i.v.) infusions and additional analgesics were given on demand. Pain scores were assessed on a visual analogue scale. Close clinical control and laboratory checks were performed during the three-day study period.
Patients receiving buprenorphine were significantly less likely to demand additional analgesics (1 versus 14 patients; P < 0.0001). The pain scores for patients in the buprenorphine group were significantly lower over the treatment period in comparison to procaine (P < 0.05). The reduction of pain score was significantly greater during the initial two treatment days using buprenorphine (day 1: 55 versus 25, P < 0.0001; day 2: 62 versus 40, P = 0.005). Side effects were comparable for both groups with the exception of a slightly higher sedation rate under buprenorphine.
Constant i.v. application of buprenorphine is more effective than the recommended procaine for pain relief in acute pancreatitis.
评估丁丙诺啡和普鲁卡因对急性胰腺炎患者的镇痛效果及副作用。
40例急性胰腺炎或慢性胰腺炎急性发作患者（平均年龄50岁；男性23例）被前瞻性随机分组，分别接受丁丙诺啡或普鲁卡因以缓解疼痛。两种镇痛药均持续静脉输注，并按需给予额外镇痛药。采用视觉模拟评分法评估疼痛评分。在为期三天的研究期间进行密切的临床监测和实验室检查。
接受丁丙诺啡治疗的患者需要额外镇痛药的可能性显著降低（1例对14例；P<0.0001）。与普鲁卡因相比，丁丙诺啡组患者在治疗期间的疼痛评分显著更低（P<0.05）。使用丁丙诺啡治疗的最初两天，疼痛评分的降低幅度显著更大（第1天：55对25，P<0.0001；第2天：62对40，P=0.005）。除丁丙诺啡治疗下的镇静率略高外，两组的副作用相当。
在急性胰腺炎的疼痛缓解方面，持续静脉应用丁丙诺啡比推荐使用的普鲁卡因更有效。
