Summary
This report concerns 23 patients, the majority of whom are suffering from low back and chest pain caused by chest, urological or gynaecological cancer.
These patients were treated with subarachnoid burpenorphine, administered in a single bolus or by slow infusion from micropumps, at a daily dose adapted to patient's need (0.06–0.15 mg). The painful symptomatology was successfully controlled in all the cases treated, allowing the patients to live a virtually normal life. In no cases was respiratory depression or tolerance observed.
Similar content being viewed by others
References
Abboud TK, Shnider SM, Dailey PA, Raja JA, Sarkis F, Grobler N, Knoo SS, Desousa B, Baysinger CL, Miller F (1984) Intrathecal administration of hyperbaric morphine for the relief of pain in labour. Br J Anaesth 56: 1351–1360
Ahlgren FIH, Ahlgren MBE (1987) Epidural administration of opiates by a new device. Pain 31: 353–357
Barillà S (1984) Confronto fra buprenorfina e morfina somministrate per via peridurale continua nel trattamento del dolore cronico da cancro. In: Atti 36∘ Congr Naz Soc Ital Anest Analg Rianim e Terap Intens, Bari 11–14 ottobre 1984. Laterza Ed, Bari, pp 283–286
Bilsback RP, Rolly B (1982) A double-blind epidural administration of lofentanil, buprenorphine or saline for post-operative pain. Anaesthesia, 6th Europ Congr Anaesth, p49
Bullingham RES, McQuay HG, Moore RA (1982) Extradural and intrathecal narcotics. In: Atkinson RS, Hewes CL (eds) Rec Adv Analg, vol 14, Churchill Livingstone, New York, pp 141–156
Cahill J, Murphy D, O'Brien D, Mulhall J, Fitzpatrick G (1983) Epidural buprenorphine for pain relief after major abdominal surgery. Anaesthesia 38: 760–764
Carl P, Crawford ME, Ravlo O, Bach V (1986) Longterm treatment with epidural opioids. A retrospective study comprising 150 patients treated with morphine chloride and buprenorphine. Anaesthesia 41: 32–38
Chrubasik J (1987) Spinal infusion of opiates and somatostatin. Acta Neurochir [Suppl 38]: 80–81
Chrubasik J, Vogel W, Trötscheler H, Farthmann EH (1987) Continuous-plus-on-demand epidural infusion of buprenorphine versus morphine in postoperative treatment of pain. Postoperative epidural infusion of buprenorphine. Arzneim-Forsch/Drug Res 37 3: 361–363
Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. Anaesthesiology 61: 276–310
Cowan A, Lewis JW, Macfarlane IR (1977) Agonist and antagonist properties of buprenorphine, a new antinociceptive agent. Br J Pharmacol 60: 537–545
De Castro J (1979) Use of narcotic antagonists in anaesthesia. Br J Clin Pharmac 7: 319S-321S
De Castro J, Andrieu S, Boogaerts J (1982) Buprenorphine: a review of its pharmacological properties and therapeutical uses. Ars Medici, Antwerpen (New Drug Series 1 M & I)
Devaux C, Tessier C, Zickler P, Deshayes P, Oksenhendler G, Winckler C (1982) Subarachnoid opiates. A comparative study of morphine, phenoperidine, fentanyl, sulfentanyl and buprenorphine. In: 6th Europ Congr Anaesth, London, September 1982. Academic Press, pp 47–48
Dezzani V, Francone L, Mulatero S, Remodino M (1987) Esperienza clinica con 1'uso dell'associazione bupivacaina-buprenorfina nelle anestesie sottoaracnoide e in chirurgica ortopedicotraumatologica del paziente anziano. Min Anest 53 1–2: 9–18
Dobkin AB, Esposito B, Philbin C (1977) Double-blind evaluation of buprenorphine hydrochloride for post-operative pain. Canad Anaesth Soc J 24: 195–202
Franetzki M, Kollert D (1987) Externally portable and implantable devices for continuous delivery of analgesics. Acta Neurochir [Suppl 38]: 76–79
Hanaoka K, Itoh S, Kuginaja T, Tachibana N, Yamura H (1982) Analgesic effects of burpenorphine on postoperative pain by epidural injection. Anaesthesia, 6th Europ Congr Anaesth, pp 223–224
Heel RC, Brogden RN, Speight TM, Avery GS (1979) Buprenorphine: a review of its pharmacological properties and therapeutic efficacy. Drugs 17 2: 81–110
Hovell BC, Ward AE (1977) Pain relief in the post-operative period: a comparative trial of morphine and a new analgesic buprenorphine. J Int Med Res 5 6: 417–421
Kay B (1978) A double-blind comparison of morphine and buprenorphine in the prevention of pain after operation. Br J Anaesth 50: 605–609
Kjaer M, Henriksen H, Kundesen J (1982) A comparative study of intramuscular buprenorphine and morphine in the treatment of chronic pain of malignant origin. Br J Clin Pharmacol 13: 487–492
Laugner B, Muller A, Thiebaut JB, Farcot JM (1985) Analgesie par site implantable pour injections intrathecales iteratives de morphine. Analgesia with repeat intraspinal morphine injections via an implanted device. Ann Fr Anesth Reanim 4: 511–520
Lazorthes Y, Cros J, Verdie JC, Lagarrigue J, Bastide G, Boetto S (1982) Morphine intrarachidienne chronique dans le traiment des douleurs d'origine néoplasique. Med et Hyg 40: 1983–1989
Marena L, Comelli G, Luzzani M, Gottlieb A (1986) Utilizzazione protratta di buprenorfina parenterale nel dolore neoplastico. Algos 3 2: 149–153
Moore A, Bullingham R, McQuay H, Allen M, Baldwin D, Cole A (1984) Spinal fluid kinetics of morphine and heroin. Clin Pharmacol Ther 35: 40–45
Orwin JM (1977) Buprenorphine pharmacological aspects in man. In: Harcus AWet al (eds) Pain—New Perspective in Measurement and Management. Churchill Livingstone, Edinburgh, p 141
Pasqualucci V, Tantucci C, Paoletti F, Dottorini ML, Bifarini G, Belfiori R, Berioli MB, Grassi V, Sorbini CA (1987) Buprenorphine vs morphine via the epidural route: a controlled comparative clinical study of respiratory effects and analgesic activity. Pain 29: 273–286
Penn RD, Paice JA, Gottschalk W, Ivankovich AD (1984) Cancer pain relief using chronic morphine infusion. Early experience with a programmable implanted drug pump. J Neurosurg 61: 302–306
Rolly G, Versichelen L (1976) Buprenorphine as postoperative analgesic. Acta Anaestesiol Belg 27 3: 183–186
Rondomanska M, de Castro J, Lecron L (1982) The use of epidural buprenorphine for the treatment of postoperative pain. In: Yaksh TLet al (eds) Spinal and Opiate Analgesia. Springer, Berlin Heidelberg New York (Anästhesiologie und Intensivmedizin, vol 144, pp 91–94
Sciandra G, Bono D, Coaloa M, Garelli G, Piazza L, Viglietti AM (1984) Studio comparativo tra burpenorfina e morfina nel controllo del dolore nell'immediato post-operatorio per via peridurale. Min Anest 50: 607–614
Srivastava S (1982) Epidural buprenorphine for postoperative pain relief. Anaesthesia 37 6: 699
Ventafridda V, De Conno F, Guarise G (1983) Chronic analgesic study of buprenorphine action in cancer pain. Arzneim-Forsch/Drug Res 33 4: 587–590
Yaksh TL (1985) I principi alla base dell'uso die narcotici spinali. In: Bullingham R.E.S. (ed) L'analgesia da oppiacei. Verduci, Rome, pp 223–236
Zenz M, Piepenbrock S (1985) Epidural opiates: long-term experiences in cancer pain. Klin Wochenschr 63: 225–229
Zenz M, Piepenbrock S, Hübner B, Glocke M (1981) Peridurale Analgesie mit Burpenorphine und Morphine bei postoperativen Schmerzen. Anästh Intensivther Notfallmed 16: 333–339
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Francaviglia, N., Silvestro, C., Carta, F. et al. Subarachnoid buprenorphine administered by implantable micropumps. Acta neurochir 102, 62–68 (1990). https://doi.org/10.1007/BF01402188
Issue Date:
DOI: https://doi.org/10.1007/BF01402188