COMPARATIVE-STUDY OF BUPRENORPHINE ALONE AND IN COMBINATION WITH KETOPROFEN AND PROPACETAMOL FOR POSTOPERATIVE ANALGESIA IN UROLOGIC SURGERY

Objective: To compare the analgesic effect of subcutaneous buprenorphi ne alone and in combination with propacetamol and ketoprofen following urologic surgery. Study design: Open randomized clinical trial. Patie nts: Sixty ASA II/III patients undergoing urologic surgery. Methods: T he patients were randomized into three groups to receive either bupren orphine (0.3 mg subcutaneous) on demand (group 1, n = 20), or a combin ation of buprenorphine (0.3 mg)- propacetamol (2 g)- ketoprofen (100 m g) by intravenous route over 2 hours followed by an infusion of propac etamol (2 g and ketoprofen (100 mg) at a constant rate over. The remai ning 22 hours (group 2, n = 20), or the same loading dose as in group 2 porlonged by a continuous infusion of buprenorphine (0.3 mg), propac etamol (2 g) and ketoprofen (100 mg) over the same period (group 3, n= 20). Visual analogue scale pain scores (0-10) were assessed every hou r during the 24 hours of the study. When the VAS score exceeded 5, an additional dose of 0.3 mg of buprenorphine was administered. Results: Groups were similar for age, surgery, anaesthesia and initial pain lev els. Compared to group 1, the onset of analgesia was earlier in groups 2 and 3 at the 1 st hour (P < 0.05); the level of analgesia was lower at the 3rd hour (P < 0.05). The maintenance of this analgesia level r equired constant buprenorphine administration. Buprenorphine requireme nts were decreased to 56% and 37% in groups 2 and 3 respectively, comp ared to group 1 (P < 0.05). incidence of nausea and vomiting was lower ed to 15% in group 3 (P < 0.05). Conclusion: A combination of buprenor phine, propacetamal and ketoprofen provides effective postoperative an algesia with a low incidence of nausea and vomiting and decreased requ irements of buprenorphine.