Efficacy of postoperative pain treatment regimens using both buprenorphine and papaveretum sequentially after abdominal hysterectomy.

We have undertaken a double-blind, controlled study to test the hypothesis that the efficacy of standard postoperative analgesia by papaveretum or buprenorphine is not compromised by previous or subsequent standard doses of the other agent. After total abdominal hysterectomy under a standardized general anaesthetic, 120 patients (four groups of 30) were allocated randomly to receive, on demand, a single i.v. dose of buprenorphine 0.15 mg or papaveretum 10 mg, followed sequentially by a single dose of i.m. buprenorphine 0.3 mg or papaveretum 20 mg. Three hours after the i.m. dose, all patients received sublingual buprenorphine 0.4 mg. Pain was scored using both a 10-cm horizontal visual analogue scale (VAS) and a nominal scale. Pain intensity differences and patient and nurse satisfaction with the regimens were recorded. Observations were continued for 8 h after operation. The efficacy of papaveretum or buprenorphine was not compromised by previous or subsequent standard doses of the other agent. All four treatment regimens were similarly well tolerated and gave acceptable analgesia in the immediate postoperative period.