S.A.R. Gardezi ( Department of Surgery, North Surgical Unit No. 1, Mayo Hospital, King Edward Medical College, Lahore-Pakistan. )
H. Shafique Ahmed ( Department of Surgery, North Surgical Unit No. 1, Mayo Hospital, King Edward Medical College, Lahore-Pakistan. )
Abdul Majid Chaudhary ( Department of Surgery, North Surgical Unit No. 1, Mayo Hospital, King Edward Medical College, Lahore-Pakistan. )
Ijaz Ahmed ( Department of Surgery, North Surgical Unit No. 1, Mayo Hospital, King Edward Medical College, Lahore-Pakistan. )
Buprenorphine has been shown to be an effective analgesic agent. In this trial buprenorphine was found as an effective analgesic agent in most of surgical emergencies; same was true for post operative cases. The duration of analgesia in this study was found to be nearly 8 hours as compared with morphine which was 5-1/2 hours. In another study after operations (Royll and Versichelas, 1976) the duration of analgesia following 4 ug/kg of buprenorphine was at least 6 hours. The drug has a low frequency of side effects. Respiratory depression is known to occur with buprenorphine. In a study of Orwin and Robson (1976) the respiratory effects of equianalgesic doses of buprenorphine and morphine were similar (JPMA 31:250, 1981).
Buprenorphine is a new synthetic analgesic agent derived from thebaine (Lewis, 1974) and is closely related in structure to morphine. Boura and Fitzgerald (1966) found buprenorphine to be 50 times more potent compared with morphine in mice, rat and dog. Clinical trials in man (Hovell, 1976) showed that buprenorphine is safe, potent and long acting analgesic which was equally useful in the treatment of pain after surgery.
Prolonged administration in monkeys and mice does not produce addiction. Peak concentrations in man are found 10-30 minutes after M injection. Excretion of buprenorphine is relatively slow and the principal route is faeces. It is mata-bolised in the liver but mostly unchanged buprenorphine is found in the faeces.
Object of the Trial
The object of the trial was to assess:
1. The efficacy of buprenorphine as an analgesic in all sorts of general surgical emergencies.
2. A comparative study of buprenorphine with morphine as analgesic in post operative patients. In the latter group buprenorphine and morphine were compared for the duration of pain relief in the post operative period and adverse reactions if any of both the drugs were noted.
The authors are grateful for the help and assistance of Dr. Tanveer A. Naveed Bhatti, Registrar, N.S.W., Dr. S.N.H Kazmi, M.O., Dr. Modood Ali, Senior House Surgeon, N.S.W., Dr. S. Athar Ali Bokhari, Senior House Surgeon, N.S.W., and staff Nurse Nusrat Saeeda and Staff Nurse Zaib-un-Nisa. Thanks are also due to Messrs Abdul Ghaffar Naeem and Muhammad Aslam Javed of Postgraduate Medical Institute, Lahore.
1. Boura, A.L. and Fitzgerald, A.E. (1966) The pharmacology of N-(CyclopropyIemethyl)-19 isopentylnosovinol hydrochloride. A potent and long lasting Central depressant. Br. J. Pharmacol., 26:307.
2. Hovell, B.C. (1976) Buprenorphine. Clinical trial in Postoperative pain by intramuscular route. Sixth World Cong. Anaesthesiol 387 18 Excerpta Medica International Congress Series.
3. Lewis, J.W. Ring C-bridged derivatives of thebaine and oripavine. Narcotic antagonists, in advances in biochemical psychopharmacology eds M.C. Villarreal. New York, Ravan Press, Vol. 8 pp. 123, 1974.
4. Orwin, J.M. and Robson, P.J. (1976) Effects of buprenorphine and morphine on respiration following administration by the intramuscular route in man. VI Congr. Mond. Anaesthesiol Section S.S.
5. Roily, G. and Versichelen, L. (1976) A first experience with a new analgesic drug: Buprenorphine. Sixth World Congress of Anesthesiology, 387, 19. Excerpta Medica, Inter national Congress Series.