An oral buprenorphine and paracetamol combination compared with paracetamol alone: a single dose double-blind postoperative study.

1 An oral combination of buprenorphine and paracetamol was compared with paracetamol alone in a single dose, double-blind postoperative study. One hundred and twenty patients undergoing elective minor orthopaedic operations were allocated to four groups of 30 patients. The four treatments were 1,1.5 or 2 mg of buprenorphine with paracetamol 1,000 mg or paracetamol 1,000 mg alone. 2 There were no significant differences between the groups in analgesia measured by the observer over the 6 h period of direct observations. The oral opiate produced a significant increase in duration of analgesia beyond the 6 h study period. A significant increase in side-effects was seen only at the highest buprenorphine dose compared with paracetamol. 3 The problems of trial design for analgesic combinations are considered. Drug mixtures create additional complexities which decrease the certainty of the conclusion that no real benefits result from such mixtures.