• L Lacoste, D Thomas, J L Kraimps, M Chabin, P Ingrand, J Barbier, and J Fusciardi.
• Department of Anesthesiology and Surgical Intensive Care, Jean Bernard University Hospital, Poitiers, France.
• J Clin Anesth. 1997 May 1;9(3):189-93.

Study ObjectiveTo compare three analgesic regimens for pain relief after thyroidectomy.DesignRandomized, double-blind, placebo-controlled study.SettingInpatient anesthesia in a university department of endocrine surgery.Patients342 patients scheduled for elective thyroidectomy with nitrous oxide-oxygen-isoflurane anesthesia in addition to fentanyl.InterventionsGroup 1 received preoperative oral controlled release morphine 10 mg, and Group 2 received postoperative sublingual buprenorphine 0.2 mg. Group 3 received 0.25% bupivacaine (10 ml) wound infiltration before skin closure. Eight hours after tracheal extubation, patients received a second dose of the same drug in each group except in Group 3, where medication was changed to sublingual buprenorphine 0.2 mg.Measurements And Main ResultsPatients in Group 2 required fewer additional analgesics: 0.54 +/- 0.68 vs. 0.96 +/- 0.84 in Group 1 and 0.79 +/- 0.78 in Group 3. Patients in Group 2 demonstrated a better pain score and this group showed a higher percentage of satisfied patients: 96% vs. 85% in Group 1 and 91% in Group 3. Group 2 also included more patients requiring no analgesics: 56% vs. 32% in Group 1 and 42% in Group 3. The side effects in all three groups did not differ.ConclusionThe administration of sublingual buprenorphine after thyroidectomy provides better analgesia than small doses of oral controlled-release morphine or than 0.25% bupivacaine wound infiltration at the end of surgery.

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