Treatment of ischemic pain in patients suffering from peripheral vasculopathy with transdermal buprenorphine plus epidural morphine with ropivacaine vs. epidural morphine with ropivacaine.
OBJECTIVE
This study compared the efficacy and safety of buprenorphine transdermal delivery system with peridural infusion of morphine and ropivacaine to peridural infusion alone for the control of ischemic pain in patients suffering from peripheral vasculopathy.


METHODS
Eighty-six patients were randomized into two groups. In the first group, a buprenorphine patch 35 microg/hour TTDS (transtec transdermal device plus ropivacaine and morphine) was applied, and a peridural infusion of ropivacaine/morphine (200 mg + 2 mg) was established. In the second group, ropivacaine and morphine analgesia was obtained using a peridural infusion and a placebo patch. The primary efficacy parameter was the visual analog scale score for pain. Secondary parameters of efficacy were the short-form McGill Pain Questionnaire scores and a score for pain interference with sleep obtained from patient diaries evaluated every week for a period of 4 weeks.


RESULTS
Subjects in the TTDS group reported a reduction in pain, increased sleep, and a lower incidence of side effects compared with the control group.


CONCLUSIONS
Transdermal buprenorphine use resulted in significant pain relief with excellent patient satisfaction, which may translate into improvement in mood and quality of life.
Aurilio
Caterina
C
Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy. caterina.aurilio@unina2.it
Pace
Maria Caterina
MC
Passavanti
Maria Beatrice
MB
Paladini
Antonella
A
Maisto
Massimo
M
Iannotti
Mario
M
Pota
Vincenzo
V
D'amora
Eleonora
E
Sansone
Pasquale
P
Barbarisi
Manlio
M
D000279:Administration, Cutaneous; D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002047:Buprenorphine / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D010147:Pain Measurement; D017060:Patient Satisfaction; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011446:Prospective Studies; D000077212:Ropivacaine; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000209:etiology; D011795:Surveys and Questionnaires
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002047:Buprenorphine; D009020:Morphine; D000077212:Ropivacaine; D003404:Creatinine