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Query: UMLS:C0027497 (nausea)
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Buprenorphine, a new powerful analgesic agent, was used to treat chest pain in patients with suspected myocardial infarction. Initial studies showed no significant changes in systemic or pulmonary artery blood pressure or in heart rate after intravenous buprenorphine. Sublingual buprenorphine also appeared effective in relieving pain, but its onset of action was considerably delayed compared with the intravenous route. A randomised double-blind controlled trial of equivalent doses of buprenorphine and diamorphine showed no significant difference between the drugs in terms of pain relief and duration of action. The occurrence of nausea, vomiting, and other side effects was similar in the two groups. The onset of action of buprenorphine was slightly but significantly slower than that of diamorphine. Since buprenorphine seems to be comparable with diamorphine in action and is not a controlled drug, it may prove useful in both general and hospital practice.
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PMID:Randomised trial comparing buprenorphine and diamorphine for chest pain in suspected myocardial infarction. 38 95

Epidural anaesthesia with local anaesthetics has become a standard method of pain relief during labour. In recent years, spinal opiates, alone and in combination with local anaesthetics, have also been tried with varying degrees of success. Buprenorphine, a potent lipophilic opiate with long duration of action, has been used in several trials for caesarean section [3, 4, 6], but not yet in spontaneous labour. The aim of the present investigation was to evaluate epidural anaesthesia with bupivacaine alone and with bupivacaine+buprenorphine in comparison with no anaesthetic treatment in control parturients. METHODS. A total of 80 healthy women during labour at full term (age 18-38 years, weight 54-107 kg) were studied to evaluate the influence of 0.3 mg buprenorphine (group BB) vs placebo (group B) added to an initial dose of 15 ml plain bupivacaine 0.33% for lumbar catheter epidural anaesthesia. Plain bupivacaine 0.25% (10 ml) without any opiate admixture was used for reinjections. The control group was made up of 48 untreated parturients. After every injection, blood pressure, heart rate and respiratory rate were measured repeatedly, as were time intervals between injections, extent of blockade, duration of labour, actual and retrospective visual analogue pain score, and side effects such as pruritus, shivering or nausea and emesis. Maternal capillary blood gases were analysed three times during labour, and Apgar scores and venous and arterial umbilical blood gas analyses were obtained immediately after delivery. RESULTS. Admixture of buprenorphine 0.3 mg significantly increased the time interval between the first and second epidural doses (B: 162 +/- 47 vs BB: 224 +/- 64 min; mean, SD; Table 2) and significantly reduced the incidence of shivering (Table 9). The incidence of instrumental delivery was comparable in all groups (bupivacaine 32.5%, bupivacaine+buprenorphine 27.5%, control 21%; n.s.). No clinically relevant differences were observed between the epidural patients in onset and duration of the block (Fig. 1), analgesic efficacy (Fig. 2), duration of spontaneous labour (BB: 8.6 +/- 3.1 h, B: 8.5 +/- 2.9 h; n.s.) and vital functions of mothers and newborns. Although some statistically significant differences between the three groups were found in some parameters of the blood gas analyses (Table 7), the clinical condition of the newborns was always acceptable; Apgar scores were not significantly different. DISCUSSION AND CONCLUSIONS. The addition of buprenorphine to bupivacaine resulted in some advantages to the mother (reduced incidence of shivering) and the anaesthetist (time lapse before first reinjection was necessary) without jeopardizing the situation of the baby. Compared with untreated control parturients, retrospective pain scores during epidural anaesthesia with bupivacaine (with or without buprenorphine) were significantly lower. No clinically relevant disadvantages of epidural anaesthesia were observed. More studies are required to evaluate whether buprenorphine admixture allows a dose reduction of bupivacaine and could then claim clearer advantages than were found in the present investigation.
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PMID:[Obstetrical peridural anesthesia with bupivacaine and buprenorphine. A randomized double-blind study in comparison with untreated controls]. 149 32

Buprenorphine and pethidine as postoperative analgesics were compared in 96 women having gynaecological operations by lower laparotomy. A fixed dose of the respective drug was given in a double-blind and double-dummy manner, initially intramuscularly and thereafter by sublingual buprenorphine (0.4 mg) or intramuscular pethidine (75 mg) at the request of the patient during the first 24 h postoperatively. Patients receiving buprenorphine had longer dose intervals and thus needed fewer doses. The analgesic effect, as assessed by a visual analog scale, was similar with both drugs. There were no significant differences between the groups regarding respiratory depression and nausea. It appears that sublingual buprenorphine is as effective and safe as intramuscular pethidine in the postoperative period.
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PMID:Sublingual buprenorphine as postoperative analgesic: a double-blind comparison with pethidine. 230 45

Twenty patients were studied in the early post-operative period after cardiac surgery with sternotomy. Buprenorphine was prescribed: 0.3 mg intra-muscularly after total recovery from anaesthesia (8th hour) then every 8 hours if requested during 72 hours. The patients auto-estimated their level of analgesia, the clinical effects were measured with regard to heart rate, systolic and diastolic arterial pressure, and respiratory rate, before, 2 and 4 hours after each injection. Buprenorphine administration produces an effective, long lasting (8 to 12 hours) analgesia. No significant changes in haemodynamic or respiratory parameters were noticed. Side effects occurred rarely: 5 cases of drowsiness, reversible by verbal stimulation, 2 of nausea and sweats, 2 retentions of urine (after vesical catheter withdrawal). Parenteral buprenorphine is satisfactory for treatment of severe thoracic pain due to sternotomy, although the oral route would be safer during effective anticoagulant treatment.
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PMID:[The use of buprenorphine in the postoperative period in heart surgery. Evaluation of its efficacy and tolerance]. 273 Oct 59

Patient-controlled analgesia (PCA) was studied during the early postoperative period. Subjects were 40 ASA I-III patients recovering from elective major and minor surgery. Buprenorphine doses of 40 micrograms each were available whenever the patients felt pain relief necessary, and were delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer). The hourly maximum dose was set at 320 micrograms with a lockout time of 1 minute. A continuous low-dose buprenorphine infusion (5 micrograms/h) was additionally administered in order to prevent catheter obstruction. The duration of the PCA period was 16.9 +/- 5.1 h (mean +/- SD). During this time, 16.1 +/- 11.3 demands per patient were recorded resulting in individual buprenorphine consumptions of 0.63 +/- 0.59 micrograms/kg/h. More buprenorphine was needed following abdominal surgery compared with orthopedic patients, although pain relief was found slightly less in the former group. Buprenorphine consumption was significantly higher in female than in male patients. Overall efficacy and patient acceptance proved to be excellent. The effectiveness of PCA was judged superior by about 93% of patients when compared with previously experienced postoperative analgesia. Side-effects (sweating, nausea, emesis) occurred in about 10% of cases but were usually of minor intensity. No circulatory or respiratory problems were observed during the PCA period.
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PMID:[Postoperative on-demand analgesia with buprenorphine]. 336 65

The analgesic potency, efficacy, duration of action and side-effects of buprenorphine (Temgesic) 0.3 mg and 0.6 mg were compared with those of pentazocine (Sosegon) 30 mg and 60 mg in 100 male patients who had undergone orthopaedic surgical procedures. The drugs were given by intramuscular injection 30 minutes before completion of the surgical procedure, and the quality of pain relief and incidence of side-effects were assessed at 30-minute intervals for at least 6 hours. Buprenorphine was shown to be safe, to be more potent and to have a longer duration of action than pentazocine, and to result in less nausea, vomiting and euphoria, but it was associated with a higher incidence of postoperative sedation than pentazocine.
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PMID:A comparison of buprenorphine and pentazocine for the relief of postoperative pain. 351 Apr 58

The postoperative analgesic efficacy of buprenorphine (Temgesic; R & C Pharmaceuticals) 0.004 mg/kg and morphine 0.15 mg/kg were compared in 60 patients, both agents given by intramuscular injection. According to patients, buprenorphine gave better analgesia. There was no difference in the number of analgesic injections the two groups received in the 24-hour postoperative period. Cardiovascular and respiratory systems were not depressed by either drug. Side-effects were not marked, nausea being the most common in both groups. Morphine had a greater effect on the mood of patients. Buprenorphine proved a satisfactory analgesic for postoperative use by intramuscular injection.
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PMID:Intramuscular buprenorphine compared with morphine for postoperative analgesia. 356 70

Buprenorphine, a new analgesic, was administered at a dose of 0.2 mg by intramuscular injection to 21 patients with acute ureteral colic. The patients consisted of 14 males and 7 females with a mean age of 42. In all cases, the diagnosis was confirmed based on intravenous urography performed after the treatment. In 19 of the 21 patients, colicky pain was reduced at least within one hour after the administration of buprenorphine. No significant changes in the pulse or blood pressure were observed. In 6 patients, mild dizziness or nausea was observed, and none of the patients required withdrawal of the treatment. Clinical use of buprenorphine was considered to the effective and safe in patients with ureteral colic.
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PMID:[Clinical effect of buprenorphine in ureteral colic]. 373 70

Buprenorphine 0.3 mg and papaveretum 20 mg, both combined with hyoscine 0.4 mg, were used as premedicants in female patients undergoing laparoscopy or abdominal hysterectomy. The effects were compared. It was found that the increase in drowsiness and tranquility was greater following buprenorphine than that following papaveretum. A low frequency of nausea was reported in the buprenorphine-hyoscine group of patients who had undergone hysterectomy. The analgesic effects of the drugs, in these doses, appeared to be similar in degree and duration.
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PMID:Comparison of buprenorphine-hyoscine and papaveretum-hyoscine as premedicants for gynaecological surgery. 622 Jul 29

Using buprenorphine as sole intravenous analgesic in balanced anaesthesia, we tried to find the most suitable dose of buprenorphine, and compared it to fentanyl, regarding analgetic, circulatory and side effects. Initial doses of 5, 10 and 15 micrograms/kg buprenorphine and 10 micrograms/kg fentanyl were compared. Peroperative analgesia was adequate with both drugs and neither gave circulatory effects of clinical significance. After buprenorphine three of 60 patients and after fentanyl five of 11 patients were given naloxone. Nausea was more common after buprenorphine. Postoperative analgesia after the last dose of buprenorphine averaged 13 h, highly significantly longer than the 2 h after fentanyl. The overall course was considered good in 93% of buprenorphine and 100% of fentanyl cases. Buprenorphine doses are discussed.
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PMID:[Buprenorphine (Temgesic) as a peroperative analgesic. A multicenter study]. 634 61


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