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Buprenorphine, benzodiazepines and respiratory depression
Author(s) -
Faroqui M.H.,
Cole M.,
Curran J.
Publication year - 1983
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1983.tb12045.x
Subject(s) - curran , buprenorphine , medicine , general hospital , citation , depression (economics) , general anaesthesia , library science , pediatrics , anesthesia , receptor , macroeconomics , opioid , botany , computer science , economics , biology
We assessed the high incidence of pain after injection of methohexitone while conducting recent studies in out-patients using methohexitone and alfentanil. We tried a combination of two methods of solution of mcthohexitone alter reports that the use of normal saline rather than water reduced thc incidence of pain from 42"; to 16",,,' and that pretreatment with lignocaine 10 mg rcduced the incidence from 64": to 16",.' Fifty successive unpremedicated patients for outpatient gynaecological surgery received either methohexitone dissolved in normal saline or water on a double blind random basis through a 23G Butterfly (Abbott) in the back of the hand. Spontancous expressions of pain. withdrawal of the hand or wincing werc classified as a painful response. Thirteen ( 5 2 9 3 of those receiving the aqueous solution complained of pain and 16 (64"J of those in the saline group. The next 100 successive patients also received either methohexitone in saline or water. bul were all pretreated with lignocaine 10 mg. Twcnty-four percent of the aqueous group and 28'; of the saline group complained of pain. The incidence of pain following injection of methohexitone has hccn reported from between 60i,and lO"<' and is higher in unpremedicated, vasoconstricted patients receiving the injection into a small vein. Numerous methods to reduce thc incidence have been advocated. none with any convincing success. We havc failed to show any significant improvement when dissolving methohexitone in saline, and despite a lower overall significant improvement when pretreating with lignocaine, the final incidence is still higher. This means that more than one in four patients will experience moderate to severe pain after injection of the methohexitone. There is no clear alternative to methohexitone at present, because of its safety record and short duration of action. We suggest that the only method definitely to reduce the incidence of pain is to site the intravenous needle in a large vein in the foream.