[Analgesia by sublingual buprenorphine in extracorporeal kidney lithotripsy].
The efficacy of sublingual buprenorphine given for premedication was assessed in 287 consecutive patients scheduled for extracorporeal shock wave lithotripsy (ESWL). The patients were randomly assigned to three groups. They were given 45 min before starting ESWL 5 mg midazolam orally in group 1 (n = 97), and 5 mg midazolam orally and 0.2 mg sublingual buprenorphine in group 2 (n = 97), and 5 mg midazolam orally and 0.4 mg sublingual buprenorphine in group 3 (n = 93). Analgesia was assessed with a simple three step verbal scale: no pain, moderate pain treated with simple analgesics (Spasfon, Viscéralgine), and exquisite pain requiring general anaesthesia. Sublingual buprenorphine provided good analgesia in 87% of group 2 patients, and 88% of group 3 patients (NS) whereas 70% of group 1 patients experienced no pain (p < 0.05). The incidence of side-effects during the 12 h following ESWL, such as nausea, vomiting and drowsiness, was higher in group 3 (31 patients) than in group 2 (13 patients) (p > 0.01). No clinical respiratory depression occurred, although 11 patients in group 3 complained of drowsiness. It is concluded that premedication with 0.2 mg of sublingual buprenorphine provides efficient analgesia for ESWL and few side-effects.
Tauzin-Fin
P
P
Departement d'Anesthésie-Réanimation III, Hôpital Pellegrin-Tripode, Bordeaux.
Saumtally
S
S
Houdek
M C
MC
Muscagorry
J M
JM
D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D002047:Buprenorphine / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D011229:Preanesthetic Medication / Q000379:methods
D004338:Drug Combinations; D002047:Buprenorphine; D008874:Midazolam
Analgésie par la buprénorphine sublinguale dans la lithotritie extracorporelle rénale.