Szczupak Mateusz, Kobak Jacek, Cimoszko-Zauliczna Maria, Krupa-Nurcek Sabina, Ingielewicz Anna, Wierzchowska Jolanta
Department of Anesthesiology and Intensive Care, Copernicus Hospital, Gdansk, Poland.
Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.
BMC Anesthesiol. 2025 Apr 26;25(1):216. doi: 10.1186/s12871-025-03084-0.
Analgesic treatment is the primary method for managing acute postoperative pain. Opioid analgesics are the main class of drugs used to treat moderate to severe pain, whether it is acute or chronic. These opioids differ in various ways, including their pharmacochemical properties, distribution and absorption rates, metabolism, and elimination pathways for the drug and its metabolites. These differences result in varying degrees of analgesic efficacy, which, in clinical practice, allows for the selection of the most effective drug that maximizes pain relief while ensuring safety. Buprenorphine is a semi-synthetic opioid with properties that are not yet fully understood. It has a wide range of applications in treating both acute and chronic pain, including non-cancer and cancer-related pain. One of the most significant clinical advantages of buprenorphine is its safety profile, which includes a ceiling effect on respiratory depression, no immunosuppressive effects, inhibition of hyperalgesia, no cumulative effects in patients with renal failure, and a low risk of constipation following its use.
This study aims to analyze current reports on the use of intravenous buprenorphine as a first-line opioid analgesic for postoperative pain relief. The paper discusses the pharmacochemical properties of the drug and the mechanisms behind postoperative pain. Additionally, it presents the experiences of the pain management team at Copernicus Hospital in Gdansk regarding administering intravenous buprenorphine.
The current literature on buprenorphine for treating moderate to severe acute pain has been reviewed, focusing on its effectiveness in managing postoperative pain following surgical procedures. Additionally, the experience of the Copernicus Hospital pain team with buprenorphine is summarized in a brief discussion.
After reviewing current literature and recommendations, along with the experiences of the pain management team at Copernicus Hospital in Gdańsk, it can be concluded that buprenorphine is an analgesic that demonstrates a high level of efficacy and safety. When used in combination with non-opioid analgesics, buprenorphine achieves a synergistic effect, resulting in effective pain relief. This approach facilitates early patient rehabilitation and enables a swift return to normal activities, even following extensive surgical procedures.
镇痛治疗是处理术后急性疼痛的主要方法。阿片类镇痛药是用于治疗中度至重度疼痛（无论是急性还是慢性疼痛）的主要药物类别。这些阿片类药物在多种方面存在差异，包括它们的药物化学性质、分布和吸收率、代谢以及药物及其代谢产物的消除途径。这些差异导致不同程度的镇痛效果，在临床实践中，这使得能够选择最有效的药物，在确保安全的同时最大程度地缓解疼痛。丁丙诺啡是一种半合成阿片类药物，其特性尚未完全明确。它在治疗急性和慢性疼痛（包括非癌性和癌性相关疼痛）方面有广泛应用。丁丙诺啡最显著的临床优势之一是其安全性，包括对呼吸抑制有封顶效应、无免疫抑制作用、抑制痛觉过敏、对肾衰竭患者无累积效应以及使用后便秘风险低。
本研究旨在分析当前关于使用静脉注射丁丙诺啡作为术后疼痛缓解的一线阿片类镇痛药的报道。本文讨论了该药物的药物化学性质以及术后疼痛背后的机制。此外，还介绍了格但斯克哥白尼医院疼痛管理团队使用静脉注射丁丙诺啡的经验。
回顾了当前关于丁丙诺啡治疗中度至重度急性疼痛的文献，重点关注其在手术操作后处理术后疼痛方面的有效性。此外，在简要讨论中总结了哥白尼医院疼痛团队使用丁丙诺啡的经验。
在回顾当前文献和建议以及格但斯克哥白尼医院疼痛管理团队的经验后，可以得出结论，丁丙诺啡是一种具有高度疗效和安全性的镇痛药。当与非阿片类镇痛药联合使用时，丁丙诺啡可产生协同效应，从而有效缓解疼痛。这种方法有助于患者早期康复，并能使患者迅速恢复正常活动，即使是在进行广泛的手术操作之后。
