Epidural Buprenorphine???A Double-Blind Study of Postoperative Analgesia and Side Effects

Buprenorphine added to the local anesthetic for axillary brachial plexus block prolongs postoperative analgesia

“…Similarly, in previous studies, 0.3 mg of epidurally administered buprenorphine was shown to produce postsurgical analgesia lasting between 3 and 12 hours, with a mean value of 6.5 hours. 14,15 This, again, would tend to negate a centrally mediated antinociceptive effect of buprenorphine in the present study, since buprenorphine-local anesthetic plexus blocks provided postoperative analgesia lasting 2 to 3 times as long as that demonstrated in the epidural buprenorphine studies. We believe a mechanism other than systemic absorption or central antinociception must be responsible for the prolonged duration of postoperative analgesia noted in the group I patients.…”

A comparison of epidural buprenorphine with epidural morphine for postoperative analgesia following stifle surgery in dogs

“…We also did not objectively assess postoperative respiratory depression. Early and delayed respiratory depression after epidural buprenorphine has been reported in humans, as indicated by a blunted CO 2 response curve (Lanz et al. 1984).…”

“…The segmental analgesia provided by epidural oxymorphone may be more profound, and exert more of a pre‐emptive effect, than oxymorphone given systemically. Buprenorphine and oxymorphone have similar lipophilicity, while buprenorphine has approximately ten times the receptor affinity for the µ receptor (Lanz et al. 1984; Stoelting 1991).…”

“…1995). In humans, delayed respiratory depression, urinary retention and pruritus have been reported following epidural morphine administration (Gustafsson et al 1982; Lanz et al. 1984).…”

Addition of 0.1% bupivacaine to buprenorphine and droperidol in patient-controlled epidural analgesia improved postoperative pain scores on coughing after gynecological surgery

“…Respiratory depression is one of the potential adverse effects of a large amount of epidural buprenorphine, and it is not readily reversed by high doses of naloxone once the effects have been produced [17]. However, previous studies have reported that epidural buprenorphine provides satisfactory postoperative analgesia, with few side effects [18,19]. In addition, as Govindarajan and colleagues [20] have noted, its pharmacologic feature of slow dissociation from l receptors could be advantageous in intermittent epidural administration; thus, our reason for choosing buprenorphine in our pure PCEA.…”