Journal of Anesthesiology and Pain

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 Aims and background: Postoperative pain is a common side effect following surgery that can postpone patient’s discharge from hospital. Pain control in orthopedic patients can significantly reduce joint movement problems and patients can easily get back to normal life. In this study we aimed to study the efficacy of sublingual Buprenorphine in postoperative pain control following orthopedic surgery of the lower limbs. Materials and methods: This double blind clinical trial was conducted on 60 patients referred for orthopedic surgery of the lower limbs. They were in classes I and II of the American Society of Anesthesiologists (ASA( and they were under spinal anesthesia. Patients were divided into two groups of Buprenorphine (0.4mg, every 8h hours( and control group (Morphine 20mg in 100cc(. This trial was practiced after surgery and in the recovery room. Amount of meperidine usage, pain score and side effects including nausea and vomiting, level of sedation and pruritis were recorded at 1, 8, 16 and 24 hours after surgery. Findings: 60 Patients in the control (Morphine) and Buprenorphine groups were studied. There was no significant difference between the two groups in terms of gender distribution (p=0.766(, average age (p=0.350(, weight (p=0.195(, ASA score (p=0.519( and operation time (p=0.510(. Average pain score in the Buprenorphine group was significantly lower than the control (Morphine) group at 8 (p=0.025), 16 (p<0.044) and 24 (p<0.003) hours after surgery. Meperidine usage in the first 24 hours after surgery in Buprenorphine group (38.5±15.60 mg) was significantly lower than the control (Morphine) group (49.33±19.02mg) (p=0.019). There was no significant difference between the two groups in terms of side effects (nausea and vomiting, level of sedation and pruritis(. Conclusion: This study showed that Sublingual Buprenorphine administration after orthopedic surgery of the lower limbs can lead to better postoperative pain control in comparison to control group (Morphine PCA pump(. Also it has minimal side effects and is compatible with Morphine in this field.

Keywords: Intravenous morphine, Sublingual Buprenorphine, Pain management, orthopedic surgery of the lower limb

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