• P Tauzin-Fin, S Delort-Laval, Y Guenard, M C Krol-Houdek, J M Muscagorry, and P Maurette.
• Département d'anesthésie-réanimation III, hôpital Pellegrin-Tondou, Bordeaux, France.
• Ann Fr Anesth Reanim. 1996 Jan 1;15(1):41-6.

ObjectiveTo compare the analgesic effect of subcutaneous buprenorphine alone and in combination with propacetamol and ketoprofen following urologic surgery.Study DesignOpen randomized clinical trial.PatientsSixty ASA II/III patients undergoing urologic surgery.MethodsThe patients were randomized into three groups to receive either buprenorphine (0.3 mg subcutaneous) on demand (group 1, n = 20), or a combination of buprenorphine (0.3 mg)-propacetamol (2 g)-ketoprofen (100 mg) by intravenous route over 2 hours followed by an infusion of propacetamol (2 g) and ketoprofen (100 mg) at a constant rate over. The remaining 22 hours (group 2, n = 20), or the same loading dose as in group 2 prolonged by a continuous infusion of buprenorphine (0.3 mg), propacetamol (2 g) and ketoprofen (100 mg) over the same period (group 3, n = 20). Visual analogue scale pain scores (0-10) were assessed every hour during the 24 hours of the study. When the VAS score exceeded 5, an additional dose of 0.3 mg of buprenorphine was administered.ResultsGroups were similar for age, surgery, anaesthesia and initial pain levels. Compared to group 1, the onset of analgesia was earlier in groups 2 and 3 at the 1st hour (P < 0.05); the level of analgesia was lower at the 3rd hour (P < 0.05). The maintenance of this analgesia level required constant buprenorphine administration. Buprenorphine requirements were decreased to 56% and 37% in groups 2 and 3 respectively, compared to group 1 (P < 0.05). Incidence of nausea and vomiting was lowered to 15% in group 3 (P < 0.05).ConclusionA combination of buprenorphine, propacetamol and ketoprofen provides effective postoperative analgesia with a low incidence of nausea and vomiting and decreased requirements of buprenorphine.

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