[Clinical use of sublingual buprenorphine hydrochloride for analgesia in the early postoperative period]. / Klinicheskoe primenenie sublingvalnoi formy buprenorfina gidrokhlorida dlia analgezii u bolnogo v rannem posleoperatsionnom periode.

Analgesic efficacy and safety of sublingual buprenorphine was assessed in 31 patients aged 20 to 79 (20 women) in the postoperative period. Moderate and intensive pain during the first hours after the patients were brought from the operation room were indications for administering the drug. It was used in 26 patients after abdominal surgery (15 through the laparoscopic access and 11 through the laparotomic one) and 5 after other operations. A single dose of buprenorphine was 0.2 to 0.4 mg; if the effect was insufficient during an hour, the dose was repeated. Maximal daily dose was 1.8 mg. If analgesia was insufficient or null, other analgesics were injected. Clinical status was assessed by the intensity of the painful syndrome (according to 4 score scale) before analgesia and during 6 h after drug administration, by the duration of analgesia, daily dose, need in other analgesics, and parameters of systemic hemodynamics (arterial and partial pressure, heart rate, monitoring of HbO2 in capillary blood). The incidence, pattern, and severity of side effects were assessed. Adequate analgesia with buprenorphine was attained in 25 (81%) patients: in 7 (64%) with intensive pain and in 17 (89%) with moderate pain. The mean duration of analgesic effect of buprenorphine was 6.6 +/- 0.6 hours. Side effects (nausea and vomiting) were observed in 2 (6.6%) patients. The drug did not appreciably affect the hemodynamics, nor did it depress respiration. Hence, sublingual buprenorphine is an effective and safe analgesic for postoperative analgesia.

[Clinical use of ketorolac (ketrodole) for analgesia in the early postoperative period]. / Klinicheskoe primenenie ketorolaka (ketrodola) dlia obezbolivaniia v rannem posleoperatsionnom periode.

Ketrodole was administered to 30 patients operated on the abdominal organs, heart and major vessels, lungs and bronchi. The drug was used in a single dose of 30 mg, the maximal daily dose being 90 mg for 16 young patients and 60 mg for 14 elderly patients. Adequate analgesia depending on the time of ketrodole use was attained in 74 to 95% of patients. In 60% of patients with medium intensive pain ketrodole may replace potent opioid analgesics or reduce their daily dose two- or threefold. Ketrodole in the doses used is a relatively safe analgesic.

[Effects of opioid analgesics on pulmonary ventilation and metabolism in patients with acute postoperative pain]. / Vliianie opioidnykh analgetikov na legochnuiu ventiliatsiiu i metabolizm u bol'nykh s ostroi posleoperatsionnoi bol'iu.

Opioid analgesics buprenorphine, nubain, and morphine were used in 33 patients suffering from acute postoperative pain on days 1-3 after operations on the lungs, heart and main vessels, abdominal organs. Buprenorphine was used in dose 0.01 mg/kg, nubain in dose 0.3 mg/kg, and morphine in dose 0.3 mg/kg. Effects of opioid analgesics on O2 consumption, carbon dioxide exhalation, minute respiration volume, and total energy metabolism were monitored. Effects of buprenorphine on metabolism and ventilation were the most manifest: it lead to reduction of metabolism by 26.2% and minute respiration volume by 36%. Nubain had no noticeable effect on metabolism or ventilation parameters. Morphine lead to moderately expressed changes in metabolism and ventilation reducing metabolism by 12.5% and minute respiration volume by 10.3%.

[The evaluation of the efficacy and safety of using nalbuphine hydrochloride (Nubain) in patients in the early postoperative period]. / Otsenka éffektivnosti i bezopasnosti primeneniia nalbufina gidrokhlorida (nubaina) u bol'nykh v rannem posleoperatsionnom periode.

Nubaine (N) was used in 92 patients operated on the lungs, heart and major vessels, abdominal organs. N at a dose of 0.3 mg/kg caused adequate analgesia in 62-85% of cases on days 1-3 after surgery; it is an effective analgesic among those used in patients with acute postoperative pain. The effect of N on circulation, respiration, gas exchange, metabolism, and hormonal status was studied. It has been shown that N is a safe agent which has no considerable effect on respiration, hemodynamics, blood gas composition, and metabolism. In patients at high risk analgesia with N caused no serious side effects.