A Comparative Study of the Epidural Buprenorphine and Morphine for Post-Cesarean Section Pain Relief

Kim, Seung Hwan; Park, Chan Heum; Song, Pil Oh; Lee, Seung Ho; Kim, In Kyu; Shin, Myoung Keun

Abstract

Buprenorphine is a semisynthetic, highly lipophilic opioid derived from thebaine and it is 30 to 40 times more potent than morphine. This study was performed to compare the clinical effects of epidural buprenorphine on postoperative pain control with those of epidural morphine in 150 cesarean deliveries. They were physical status 1 or 2 by ASA classification and randomly divided into three groups. They were administered morphine 3 mg in group I, buprenorphine 0.15 mg in group II and buprenorphine 0.3 mg in group III as first dose mixed with 0.25% bupivacaine 10 ml respectively through indwelling epidural catheter at the time of ligation of umbilical cord. Second and third doses were administered with 8 hours intervals, morphine 3 mg with N/S 10 ml was injected in group I and buprenorphine 0.15 mg with N/S 10 ml was injected in group II and III respectively. Their analgesic effects were evaluated by VAS and severity of side effects was also evaluated. The Results were as follows; 1) VAS was significantly increased in group II compared to group I and III(p<0.05). There was no significant difference between group I and III. 2) Pruritus was lesser in group II and III than group I(p<0.05). 3) There was no significant difference in nausea and vomiting. 4) None of patients had respiratory depression. The authors' findings indicate that epidural administration of buprenorphine of suitable dose may be useful in the treatment of postoperative pain.