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Buprenorphine or procaine for pain relief in acute pancreatitis. A prospective randomized study
R Jakobs1, M U Adamek, A C von Bubnoff
1Dept of Medicine C, Klinikum der Stadt Ludwigshafen GmbH, Academic Teaching Hospital of the University of Mainz, Germany.
Background:
To assess the analgesic efficacy and side effects of buprenorphine and procaine in patients with acute pancreatitis.
Methods:
Forty patients (average age, 50 years; 23 male) with acute pancreatitis or an acute bout of a chronic pancreatitis were prospectively randomized to receive buprenorphine or procaine for pain relief. Both analgesics were administered as constant intravenous (i.v.) infusions and additional analgesics were given on demand. Pain scores were assessed on a visual analogue scale. Close clinical 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 reduction of pain score was significantly greater during the initial two treatment 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 the exception of a slightly higher sedation rate under buprenorphine.
Conclusions:
Constant i.v. application of buprenorphine is more effective than the recommended procaine for pain relief in acute pancreatitis.