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• W1984651741 abstract "La douleur après césarienne est habituellement sévère mais brève. Les opiacés sont souvent prescrits et de nombreuses voies d'administration s'avèrent possibles. Cette étude compare la qualité de l'analgésie après césarienne (sous péridurale) pour deux groupes de femmes suivies pendant 36 heures et traitées par buprénorphine sublinguale (0,4 mg/6 h, n = 25) ou morphine sous-cutanée (10 mg/6 h, n = 25). Le protocole est interrompu avant la sixième, mais après la quatrième administration chez deux patientes de chaque groupe, soit en raison d'effets indésirables, soit à leur demande. L'analgésie, évaluée par une échelle visuelle analogique, est comparable pour ces doses équianalgésiques des deux morphiniques. Les signes vitaux ne sont pas modifiés. Le degré de sédation est identique dans les deux groupes, de même que la durée et l'intensité des désaturations artérielles observées lors de la surveillance continue. La fréquence des nausées est également la même, tandis qu'apparaissent plus de prurits chez les patientes recevant la morphine. This study aimed to compare the efficacy and side-effects of sublingual buprenorphine, a synthetic opioid agonist antagonist, with those of subcutaneous morphine. Fifty ASA class 1 patients were included in the study after having given their informed consent. Caesarian section was carried out under epidural block with 0.5 % bupivacaine ; no opioids were used during the procedure. The first dose of opioid was given 2 h after the first dose of bupivacaine. Patients were randomly given either 10 mg morphine (n = 25) or 0.4 mg buprenorphine (n = 25), followed by the same dose every 6 h for 36 h. When analgesia was insufficient, tablets containing dextropropoxyphene and paracetamol were given. No attempt was made to blind the study to the patient, but the investigator assessing pain was unaware of the drug given to the patient. Pain intensity was assessed before, and 2 h after each dose of opioid with a 100 mm visual scale, as well as systolic, diastolic and mean arterial blood pressures, heart and breathing rates, and Spo2. Side-effects (pruritus, nausea, vomiting, drowsiness) were also noted. In 2 patients in each group, the protocol was stopped before the 36th h, but after the fourth dose, because of side-effects, or at the patient's request. Results were similar in both groups of patients, whether for degree of pain relief, or physiological effects. There was no clinically detectable respiratory depression. Duration and intensity of episodes of arterial oxygen desaturation, and the incidence of nausea, were similar in the 2 groups ; pruritus was more common in the morphine group. Eleven patients (44 %) in the buprenorphine group had insufficient analgesia, and 12 (48 %) in the morphine group ; all these patients took dextropropoxyphene-paracetamol (18 and 16 times respectively). Eleven nurses who gave the analgesics replied to a questionnaire concerning their subjective impression concerning the 2 treatments. They considered buprenorphine to be more efficient (7/11), easier to use because not under controlled release (8/11) and the cause of less side-effects (11/11)." @default.
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• W1984651741 date "1990-01-01" @default.
• W1984651741 modified "2023-10-14" @default.
• W1984651741 title "Analgésie postopératoire après césarienne : buprénorphine sublinguale versus morphine sous-cutanée" @default.
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• W1984651741 doi "https://doi.org/10.1016/s0750-7658(05)80186-8" @default.
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