Abstract
The postoperative pain relieving effect of epidural buprenorphine infusion was evaluated in 40 patients who underwent upper abdominal surgery under anesthesia with propofol and low dose fentanyl (less than 10μg/kg). At the end of surgery, patients were randomly divided into 2 groups. 20 patients (group C) were given initially 5ml of 0.25% bupivacaine and another 20 patients (group B) were given 0.1mg of buprenorphine in 5ml 0.25% bupivacaine in bolus. Following an epidural bolus injection, continuous epidural infusion of 0.25% bupivacaine alone (group C) or 0.8mg buprenorphine in 92ml 0.25% bupivacaine (group B) was started at a rate of 2ml/hr for 48hrs with a portable disposable device. Postoperative analgesic effect at 4, 12, 24 and 48hrs after surgery was assessed by the demands for supplemental analgesic (none, once and more than twice), visual analogue scale (VAS) at rest graded from 0 to 100mm, and Prince Henry Pain Scale graded from point 0 to 4. In group B, the average VAS was less than 20mm and nobody at rest had pain. Postoperative analgesia in group B was significantly superior to that in group C at all points in the study. We conclude that buprenorphine is effective for postoperative pain relief after anesthesia with low dose fentanyl.
