Buprenorphine suppository (BSP) has been available as an
analgesic agent in Japan since 1990. It has gained considerable popularity in various clinical situations; however, its usefulness for
postoperative pain relief has been controversial. The present study is addressed to
postoperative pain in fifty-seven women who underwent transvaginal
hysterectomy under
spinal anesthesia with
tetracaine and
phenylephrine. We examined the
analgesic effects of
buprenorphine (0.4 mg) suppository. Patients were divided into four groups according to the timing of
buprenorphine suppository administration: group A1, preoperative administration of BSP, n = 12; group A2, postoperative administration of BSP, n = 17; group A3,
intravenous injection of 0.1 mg of
buprenorphine during surgery and postoperative administration of BSP, n = 14; group C, control group, n = 14. All the patients in group C complained of
pain within 24 hr. The onset time of
pain after surgery was significantly longer in patients in group A1 (372 +/- 220 min) and A3 (481 +/- 161 min) than in control group C (282 +/- 97 min). The percentage of patients who did not complain of
pain within 24 hr was the largest in group A3 (36%). However there were no significant differences in age,
body weight, effective
analgesic time,
analgesic level or operation time among the four groups.
Nausea and
vomiting were observed in all groups: C (36%), A1 (41%), A2 (18%), and A3 (29%). From these results, we conclude that preoperative or intraoperative administration of
buprenorphine is useful for control of
postoperative pain; the method of administration of
buprenorphine suppository needs further study.