Lebedeva R N, Nikoda V V, Petrov R O, Kuleshova L A
Scientific Center of Surgery RAMN, Moscow
Anesteziol Reanimatol. 1996 Jul-Aug(4):22-5.
Analgesic efficacy and safety of sublingual buprenorphine was assessed in 31 patients aged 20 to 79 (20 women) in the postoperative period. Moderate and intensive pain during the first hours after the patients were brought from the operation room were indications for administering the drug. It was used in 26 patients after abdominal surgery (15 through the laparoscopic access and 11 through the laparotomic one) and 5 after other operations. A single dose of buprenorphine was 0.2 to 0.4 mg; if the effect was insufficient during an hour, the dose was repeated. Maximal daily dose was 1.8 mg. If analgesia was insufficient or null, other analgesics were injected. Clinical status was assessed by the intensity of the painful syndrome (according to 4 score scale) before analgesia and during 6 h after drug administration, by the duration of analgesia, daily dose, need in other analgesics, and parameters of systemic hemodynamics (arterial and partial pressure, heart rate, monitoring of HbO2 in capillary blood). The incidence, pattern, and severity of side effects were assessed. Adequate analgesia with buprenorphine was attained in 25 (81%) patients: in 7 (64%) with intensive pain and in 17 (89%) with moderate pain. The mean duration of analgesic effect of buprenorphine was 6.6 +/- 0.6 hours. Side effects (nausea and vomiting) were observed in 2 (6.6%) patients. The drug did not appreciably affect the hemodynamics, nor did it depress respiration. Hence, sublingual buprenorphine is an effective and safe analgesic for postoperative analgesia.
对31例年龄在20至79岁之间的患者（20例女性）在术后使用舌下含服丁丙诺啡的镇痛效果和安全性进行了评估。患者从手术室转出后的最初几个小时内出现中度和重度疼痛是使用该药物的指征。26例患者在腹部手术后使用（15例通过腹腔镜手术，11例通过开腹手术），5例在其他手术后使用。丁丙诺啡的单次剂量为0.2至0.4毫克；如果一小时内效果不佳，则重复给药。最大日剂量为1.8毫克。如果镇痛效果不足或无效，则注射其他镇痛药。通过镇痛前和给药后6小时内疼痛综合征的强度（根据4分制评分）、镇痛持续时间、日剂量、对其他镇痛药的需求以及全身血流动力学参数（动脉压和分压、心率、毛细血管血中血红蛋白氧饱和度监测）评估临床状况。评估副作用的发生率、类型和严重程度。25例（81%）患者使用丁丙诺啡后获得了充分镇痛：7例（64%）重度疼痛患者和17例（89%）中度疼痛患者。丁丙诺啡的平均镇痛效果持续时间为6.6±0.6小时。2例（6.6%）患者出现副作用（恶心和呕吐）。该药物对血流动力学没有明显影响，也不抑制呼吸。因此，舌下含服丁丙诺啡是一种有效且安全的术后镇痛药。
