Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine

Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy o...

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Main Authors: Shaabanali Alizadeh, Ghafar‏ ‏Ali Mahmoudi, Hassan Solhi, Bahman Sadeghi-Sedeh, Reza Behzadi, Amir Mohammad Kazemifar
Format: Article
Language:English
Published: Kerman University of Medical Sciences 2015-01-01
Series:Addiction and Health
Subjects:
Online Access:https://ahj.kmu.ac.ir/article_84642_74f13b1875f24625278526f0d7de32ca.pdf
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author Shaabanali Alizadeh
Ghafar‏ ‏Ali Mahmoudi
Hassan Solhi
Bahman Sadeghi-Sedeh
Reza Behzadi
Amir Mohammad Kazemifar
author_facet Shaabanali Alizadeh
Ghafar‏ ‏Ali Mahmoudi
Hassan Solhi
Bahman Sadeghi-Sedeh
Reza Behzadi
Amir Mohammad Kazemifar
author_sort Shaabanali Alizadeh
collection DOAJ
description Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. Methods: A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h. Findings: VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. Conclusion: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.
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spelling doaj.art-dd365d4267764b1da1ea5e923637d9282023-09-19T06:51:07ZengKerman University of Medical SciencesAddiction and Health2008-46332008-84692015-01-0171-2606584642Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual BuprenorphineShaabanali Alizadeh0Ghafar‏ ‏Ali Mahmoudi1Hassan Solhi2Bahman Sadeghi-Sedeh3Reza Behzadi4Amir Mohammad Kazemifar5Assistant Professor, General Surgeon, Department of Surgery, School of Medicine, Arak ‎University of Medical Sciences, Arak, IranAssistant Professor, Legal Medicine and Clinical Toxicologist, Department of Internal ‎Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, IranAssociate Professor, Clinical Toxicologist, Department of Emergency Medicine, School of ‎Medicine, Arak University of Medical Sciences, Arak, IranAssistant Professor, Epidemiologist, Department of Public Health, School of Medicine, Arak ‎University of Medical Sciences, Arak, IranResearcher, Department of Emergency Medicine, School of Medicine, Arak University of ‎Medical Sciences, Arak, IranAssociate Professor, Clinical Toxicologist, Department of Internal Medicine, School of ‎Medicine, Qazvin University of Medical Sciences, Qazvin, IranBackground: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. Methods: A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h. Findings: VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. Conclusion: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.https://ahj.kmu.ac.ir/article_84642_74f13b1875f24625278526f0d7de32ca.pdfbuprenorphinemorphinepost-operative painopioid dependencewithdrawal syndrome
spellingShingle Shaabanali Alizadeh
Ghafar‏ ‏Ali Mahmoudi
Hassan Solhi
Bahman Sadeghi-Sedeh
Reza Behzadi
Amir Mohammad Kazemifar
Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
Addiction and Health
buprenorphine
morphine
post-operative pain
opioid dependence
withdrawal syndrome
title Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
title_full Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
title_fullStr Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
title_full_unstemmed Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
title_short Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine
title_sort post operative analgesia in opioid dependent patients comparison of ‎intravenous morphine and sublingual buprenorphine
topic buprenorphine
morphine
post-operative pain
opioid dependence
withdrawal syndrome
url https://ahj.kmu.ac.ir/article_84642_74f13b1875f24625278526f0d7de32ca.pdf
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