Effect of balanced analgesia with buprenorphine on pain response and general anaesthesia requirement during lithotripsy procedures.
The effectiveness of a balanced analgesia with buprenorphine ketoprofen-propacetamol for pain control during extracorporeal shock wave lithotripsy (ESWL) was evaluated in order to reduce the requirements for general anaesthesia. Two hundred and ninety-one consecutive patients were included in a randomized, placebo-controlled, double-blind study. Patients in each group received midazolam 5 mg pre-operatively as premedication. The subjects then received either placebo (group 1), buprenorphine 0.3 mg (group 2) or the combination buprenorphine 0.3 mg plus ketoprofen 100 mg and propacetamol 2 g (group 3) intravenously (i.v.) at a constant rate. The treatment was started 45 min prior to ESWL. Pain was assessed using a three-point verbal scale: (0)no pain; (1) moderate pain; and (2) intense pain needing general anaesthesia. The patients assessed their pain intensity on a 0-100 mm visual analogue scale. Only 69% of group 1 patients received ESWL with midazolam premedication. Buprenorphine provided good analgesia in 87% of group 2 patients, while the combination buprenorphine-ketoprofen-propacetamol was effective in 99% of group 3 patients (P < 0.05). The incidence of nausea and vomiting was similar in the buprenorphine groups. No respiratory depression was reported. In conclusion, the buprenorphine-ketoprofen-propacetamol combination provided effective analgesia, allowing ESWL to be performed without the need for general anaesthesia.
Tauzin-Fin
P
P
Department of Anaesthesia, Université Victor Segalen Bordeaux, Hopital Pellegrin-Tondu, France.
Delort-Laval
S
S
Krol-Houdek
M C
MC
Maurette
P
P
Bannwarth
B
B
D000082:Acetaminophen / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000768:Anesthesia, General; D002047:Buprenorphine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use; D007669:Kidney Calculi / Q000628:therapy; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011292:Premedication
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D002047:Buprenorphine; C063776:propacetamol; D007660:Ketoprofen