Buprenorphine or procaine for pain relief in acute pancreatitis - A prospective randomized study

Background: To assess the analgesic efficacy and side effects of buprenorph ine and procaine in patients with acute pancreatitis. Methods: Forty patien ts (average age, 50 years; 23 male) with acute pancreatitis or an acute bou t of a chronic pancreatitis were prospectively randomized to receive bupren orphine or procaine for pain relief. Both analgesics were administered as c onstant intravenous (i.v.) infusions and additional analgesics were given o n demand. Pain scores were assessed on a visual analogue scale. Close clini cal control and laboratory checks were performed during the three-day study period. Results: Patients receiving buprenorphine were significantly less likely to demand additional analgesics (1 versus 14 patients: P < 0.0001). The pain scores for patients in the buprenorphine group were significantly lower over the treatment period in comparison to procaine (P < 0.05). The r eduction of pain score was significantly greater during the initial two tre atment days using buprenorphine (day 1: 55 versus 25, P < 0.0001; day 2: 62 versus 40, P= 0.005). Side effects were comparable for both groups with th e exception of a slightly higher sedation rate under buprenorphine. Conclus ions: Constant i.v. application of buprenorphine is more effective than the recommended procaine for pain relief in acute pancreatitis.