Sublingual buprenorphine as postoperative analgesic: a double-blind comparison with pethidine

Buprenorphine and pethidine as postoperative analgesics were compared in 96 women having gynaecological operations by lower laparotomy. A fixed dose of the respective drug was given in a double-blind and double-dummy manner, initially intramuscularly and thereafter by sublingual buprenorphine (0.4 mg) or intramuscular pethidine (75 mg) at the request of the patient during the first 24 h postoperatively. Patients receiving buprenorphine had longer dose intervals and thus needed fewer doses. The analgesic effect, as assessed by a visual analog scale, was similar with both drugs. There were no significant differences between the groups regarding respiratory depression and nausea. It appears that sublingual buprenorphine is as effective and safe as intramuscular pethidine in the postoperative period.