Double‐blind, Multiple‐dose Comparison of Buprenorphine and Morphine in Postoperative Pain

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Abstract
The analgesic profile and side-effects of buprenorphine (0.3 mg) and morphine (10 mg) given i.m. were compared postoperatively in a double-blind, non-crossover, multiple-dose study. When the patient complained of moderate to severe postoperative pain after halothane-relaxant anaesthesia for upper abdominal surgery, the 1st test dose of either drug was given. Subsequent similar doses of buprenorphine or morphine were given when required (maximum 10 doses). The 1st dose of both drugs gave an equal decrease in pain intensity, suggesting a relative potency of 33:1 for buprenorphine/morphine. A mean of 0.51 mg buprenorphine or 17 mg morphine to be administered for satisfactory initial analgesia. Thereafter, the next analgesic dose was required a mean of 10.3 h after buprenorphine compared to 5.9 h after morphine (P < 0.01). Significantly (P < 0.01) fewer analgesic doses (mean 5.6) were needed in the buprenorphine group within the 1st 48 h postoperatively as compared to the morphine group (mean 7.3). A more pronounced mean decrease in the respiratory rate was observed after buprenorphine but the mean minimum respiratory rates did not differ significantly from each other. Other effects of the 2 drugs on vital signs were similar. The incidence of other side-effects was fairly similar after both analgesics. The patients'' subjective apprasial favored buprenorphine.