Shaabanali Alizadeh - Assistant Professor, General Surgeon, Department of Surgery, School of Medicine, Arak ‎University of Medical Sciences, Arak, Iran
Ghafar Ali Mahmoudi - Assistant Professor, Legal Medicine and Clinical Toxicologist, Department of Internal ‎Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
Hassan Solhi - Associate Professor, Clinical Toxicologist, Department of Emergency Medicine, School of ‎Medicine, Arak University of Medical Sciences, Arak, Iran
Bahman Sadeghi-Sedeh - Assistant Professor, Epidemiologist, Department of Public Health, School of Medicine, Arak ‎University of Medical Sciences, Arak, Iran
Reza Behzadi - Researcher, Department of Emergency Medicine, School of Medicine, Arak University of ‎Medical Sciences, Arak, Iran
Amir Mohammad Kazemifar - Associate Professor, Clinical Toxicologist, Department of Internal Medicine, School of ‎Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. Methods: A total of ۶۸ patients, aged ۲۰-۶۰ years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively ۱, ۶, and ۲۴ h after the surgery. They received either morphine ۵ mg IV or buprenorphine ۲ mg SL, ۱ h after end of the surgery, and then every ۶ h for ۲۴ h. Findings: VAS was ۴.۴۷ ± ۰.۷۳ and ۲.۶۷ ± ۰.۵۳ at h ۶ and ۲۴ in buprenorphine group, respectively. The corresponding score was ۵.۸۸ ± ۰.۶۹ and ۴.۵۹ ± ۰.۷۴ in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. Conclusion: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.

Buprenorphine, Morphine, Post-operative Pain, Opioid dependence, Withdrawal syndrome