Manzoor Ahmed Faridi, Syed Inamullah Shah, Abdul Hamid Bhatti, Musharraf Imam.
Postoperative Analgesia; A comparison of sublingual Buprenorphine and intramuscular Morphine for pain relief after abdominal Hysterectomy.
Professional Med J Jan ;11(2):152-7.

Objective: To determine the effectiveness of sublingual buprenorphine in terms of duration of action, quality of analgesia, convenience of administration and safety, as compared to intramuscular morphine for postoperative analgesia after abdominal hysterectomy. Design: Prospective, randomized and comparative study. Place and duration of study: Combined Military Hospital Jhelum, from January, 2001 to October, 2003. Subjects and methods: Women undergoing abdominal hysterectomy were randomly assigned to receive postoperative analgesia with sublingual buprenorphine 0.007 mg/kg body weight or intramuscular morphine 0.2 mg/kg body weight. No analgesic was used before or during anaesthesia. First dose of analgesic was given when patients complained of pain after recovery and doses repeated on required basis. Main outcome measures was effectiveness of analgesia as measured by modified VAS and four point verbal rating scale. Secondary outcome measures were degree of sedation, respiratory rate and blood pressure. Results: Both drugs provided effective postoperative analgesia but buprenorphine provided slightly better pain relief for a much longer duration and thus required fewer doses (p=.000 as determined by Pearson chi-square test). Onset of action was slower for buprenorphine (36.8±5.7 mins) as compared to morphine (12.2±2.7 rains). Mean arterial blood pressure remained stable in buprenorphine group but slightly decreased in morphine group. Respiratory rate slightly reduced in both groups. The incidence of adverse reactions like nausea, vomiting and drowsiness were slightly more common in buprenorphine as compared to morphine group. Conclusion: Both drugs provide equally effective postoperative analgesia. Ease of administration and longer duration of action of sublingual buprenorphine make it a more acceptable option.

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