• The Korean Journal of Pain
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• v.6 no.2
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• pp.213-219
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• 1993

The use of buprenorphine by epidural route in the prevention of postoperative pain has been controversial. High lipid solubility of buprenorphine caused the same parenteral/epidural analgesic dose ratio, and the analgesic effect of epidural buprenorphine possibly due to systemic absorption, which revealed no advantages of epidural administration against parenteral injection. On the contrary, epidural buprenorphine had longer duration of action and fewer side effects than parenteral buprenorphine, which advocated the epidural use of buprenorphine. We studied the efficacy of epidural buprenorphine by comparing epidural buprenorphine with epidural morphine in terms of latency and the duration of analgesic action, and the incidence of side effects. 0.15mg and 0.3mg of epidural buprenorphine had shorter latency than 2mg of morphine. 0.3 mg of buprenorphine had longer duration of action than 4 mg of morphine. The incidence of nausea and vomiting were slightely higher in buprenorphine group than in morphine group. Voiding difficulty and pruritus were little in buprenorphine group, while the incidence of somnolence was markedly higher in buprenorphine group. Form our results we conclude that epidural buprenorphine may be useful in the treatment of postoperative pain, and but recognize both advantages and disadvantages as compared epidural morphine.

• The Korean Journal of Pharmacology
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• v.25 no.1
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• pp.23-30
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• 1989

Buprenorphine, one of the mixed agonist-antagonist opioid drugs was used to inverstigate the opioid receptor on frog sciatic nerve A fibers. Action potentials were recorded for 4 hrs by a sucrose gap apparatus which were separated by four rubber membranes. To examine the one of the mechanism of action of buprenorphine, meperidine or naloxone was added after or before the treatment of buprenorphine. The results of this experiment were as follows: 1. Buprenorphine suppressed significantly the compound action potentials of frog sciatic nerve, and the maximal effects were shown both at $10^{-4}\;M$ and at $10^{-8}\;M$. 2. The dose-response relationship of buprenorphine on the depressant effect in frog sciatic nerve was biphasic and inverted U-shaped. 3. Buprenorphine blocked the effect of Meperidine $(10^{-3}\;M)$ on this preparation. 4. The depressant effcct of Buprenorphine on frog sciatic nerve was blocked by $10^{-8}\;M$ naloxone. From the above results, buprenorphine acts as one of agoinist-antagonistic effect on frog sciatic nerve, and the opioid receptor on this preparation is located on or near the intracellular opening of the sodium channels, which are sensitive to naloxone.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.78-83
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• 1994

Morphine, a $\mu$-receptor agonist, produces strong analgesic effect with some side effects such as nausea, vomiting, urinary retension, somnolence, and respiratory depression. Buprenorphine also provides strong analgesic effects, and hemodynamic changes after continuous infusion of morphine, or buprenorphine-ketorolac combination in gynecologic patients. Analgesic effect was assessed by visual analogue scale(VAS) and Prince Henry scale(PHS). Morphine group, initial 2 mg of bolus morphine was followed by 48 mg/96 ml of continuous infusion. Buprenorphine group, initial 0.1 mg of buprenorphine was followed up with infusion by 2.3 mg/100 ml. Half dose of both initial bolus and maintenance buprenorphine with ketorolac 15 mg for bolus and 60 mg for maintenance were infused in buprenorphine-ketorolac combination group. No significant hemodynamic changes were seen in any of the groups. VAS significantly decreased after 15 minutes of infusion in all three groups, and was significantly lower in morphine group than the other 2 groups, after 60 minutes. PHS was decreased significantly 15 minutes after infusion in the morphine group, and after 60 minutes in two other groups. The incidence of side effects were similar between morphine and buprenorphine groups, but significantly reduced in buprenorphine-ketorolac combination group. We concluded that buprenorphine could be an alternative to morphine for postoperative pain, and smaller dose of buprenorphine could be used if it is combined with ketorolac with less side effects.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.80-86
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• 1988

Caudal buprenorphine was investigated as a postoperative analgesic in a randominzed double blind study of 45 patients after abdominal surgery. At the end of surgery, patients were given 0.2 mg of caudal buprenorphine in 20 ml saline(n=30, experimental group) or no injection(n=15, control group). Pain relief was evaluated by the subsequent need for systemic analgesics(pethidine). Arterial blood gas and micturition disturbance were evaluated. In the buprenophine group, use of systemic analgesics was significantly reduced for the first 24 hours postoperatively. Arterial blond gas study values 2 hollers after buprenorphine administration were within normal range. 8 patients of the buprenorphine group developed urinary retention requiring temporary Nelaton catheterization of the bladder. Caudal buprenorphine for postoperative pain control was a good alternate method of postoperative pain management.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.152-157
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• 2018

Opioid aberrant behavior is an emerging problem as strong opioid is increasingly used to alleviate cancer pain in patients with cancer. Although the treatment of opioid addiction and physical dependence for non-cancer pain is well known, few studies have been conducted with cancer patients, particularly in the Korean population. Presented here are ten cases of cancer patients who were physically dependent on strong opioid and successfully treated with a partial mu-opioid receptor agonist, buprenorphine. This is the first report showing the efficacy of transdermal buprenorphine as a treatment for physical dependence on opioid medication in cancer patients.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.151-158
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• 1996

Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid $\mu$-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can possibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and side effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg morphine (M group), 0.15 mg buprenorphine (0.15B group), 0.3 mg buprenorphine (0.3B group) combined with 0.25% bupivacaine 10ml, and subsequent continuous infusion doses were 6 mg morphine plus 0.125% bupivacine 100 ml (M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml (0.15B, 0.3B, group) during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group (P<0.05). Conclusion: The above results suggest that continuous epidural infusion of buprenorphine combined with low-dose bupivacaine is an advisable method of postoperative analgesia.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.411-417
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• 2019

Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

• Bulletin of the Korean Chemical Society
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• v.28 no.2
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• pp.183-187
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• 2007

A simple and sensitive extractive spectrophotometric method has been described for the determination of buprenorphine either in raw material or in pharmaceutical formulations. The developed method is based on the formation of a colored ion-pair complex (1 : 1 drug/dye) of buprenorphine and bromocresol green (BCG) in buffer pH 3 and extracting in chloroform. The extracted complex shows absorbance maxima at 415 nm. Beer's law is obeyed in the concentration range of 1.32-100.81 μ g mL-1. The proposed method has been applied successfully for the determination of drug in commercial sublingual tablets and injectable dosage form. No significant interference was observed from the excipients commonly used as pharmaceutical aids with the assay procedure.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.7-12
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• 2014

Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

• Korean Journal of Veterinary Research
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• v.47 no.1
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• pp.103-115
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• 2007

The aim of this study was to compare the reaction of the cardiovascular system, and the anesthetic effect among 3 experimental groups, epidural administration of medetomidine as a single agent, the combination of buprenorphine and medetomidine, and the combination of fentanyl and medetomidine. Twenty one dogs were anesthetized with isoflurane and allowed to breathe spontaneously. Epidural, arterial, and venous catheters were inserted. The tip of epidural catheter was positioned at the level of the space between the sixth and seventh lumbar vertebra. After a stable plane of anesthesia was achieved, these dogs were each administered one of the following treatments epidurally : medetomidine $10{\mu}g/kg$ (Group M), a combination of medetomidine $5{\mu}g/kg$ and buprenorphine $10{\mu}g/kg$ (Group M/B), and a combination of medetomidine $5{\mu}g/kg$ and fentanyl $10{\mu}g/kg$ (Group M/F). Heart rate (HR), Respiratory rate (RR), End-tidal carbon dioxide (EtCO2), and arterial blood pressure were measured before drug administration (base line) and 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min postinjection. Blood gas analysis was performed before injection and 5, 15, 25, 35, 45, 60 min postinjection. Isoflurane was discontinued 80 min postinjection and pain/motor function were evaluated up to 260 min postinjection every 15 min. At the early stage of drug introduction (until 5 min), the HR was decreased significantly in all 3 groups compared with base line. In Group M, HR was significantly decreased compared with the other 2 groups. With time (starting 20 min after drug introduction), the HR was decreased significantly in Group M/B in respect to base line. However, no significant difference was seen number-wise in all 3 groups. During 60 min after drug introduction, the systolic, diastolic and mean arterial pressures were highest in Group M and lowest in Group M/F. Among 3 groups, drug action and motor loss duration were longest in Group M/F. Analgesic effect observed in the M/F group was the most prominent and long-lasting, compared to those seen in the other 2 groups. Given the fact that the recovery of motor function takes place in a short period of time after analgesic effects disappeared, additional use of M/F depending on the patient's condition would be a good way to achieve effective pain management. However, proper care should be taken to ensure the function of cardiovascular system in the patient because the administration of M/F under isoflurane anesthesia results in a significant decline in arterial blood pressure ($65{\pm}10mmHg$).