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Buprenorphine reviewed

Authors: K. Budd, B.J. Collett

Title: Editorial III: Old dog – new (ma)trix

Journal: BJA, Vol 90, No. 6, 2003, pag. 722-724

Type: scientific paper published in an international human anaesthesia journal

Language: English

The Editorial III in the June 2003 issue of the British Journal of Anaesthesia is about buprenorphine and its transdermal formulation, which was introduced in clinical practice in 2001. The content of the issue is now free, and the PDF of the Editorial can be downloaded from the journal website. Although it has significant potential as a strong opioid, buprenorphine has never achieved the popularity it possibly deserves. The problem appears to be that some misconceptions arose during pre-clinical and early clinical use relating to lack of scientific studies in specific areas of its pharmacological activity. These included the ceiling effect with its implied limitation of analgesia, difficulties in understanding the ‘bell-shaped’ dose response curve, and the possible inability of other opioids to bind and be effective. In addition, some pharmacological activity of buprenorphine appears to be different in animals compared to humans. As a result, the last 25 years have seen publications refuting previous detractions, and buprenorphine is now one of the mu-agonist in the armamentarium of the anaesthetist. The paper also provides some technical data and clinical insights into the transdermal formulation that takes advantage of the new matrix technology. The 31 references quoted in the paper represents a huge source of information for the interested reader.

 

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