Introduction: Opioid dependence is recorded as the most common drug of abuse in Malaysia. Currently, the preferred substitution therapy for most Government treatment centres is methadone used as substitution therapy for opioid dependence. There are, however patients who may benefit from being on the combined buprenorphine-naloxone formulation as substitution therapy instead. We discuss six cases of opioid dependence of varied backgrounds that were treated with buprenorphinenaloxone therapy and their outcomes. Discussion: All of the reported patients improved after the induction of buprenorphine- naloxone. Two of the cases highlighted the transfer of patients on methadone to buprenorphine-naloxone due to the adverse effect and interactions of methadone with other medications. During the transfer there were no major adverse reactions noted, and patients were safely able to continue with the maintenance therapy of buprenorphine- naloxone. Conclusion: Buprenorphine-naloxone is a safe and effective drug substitution therapy for opioid dependence. It has fewer interactions with other medications, and has similar efficacy to methadone. Being a partial agonist, it has a less sedating effect making patients more functional.
Buprenorphine, Naloxone Drug Combination

No abstract available.
Buprenorphine* ; Meperidine*

No abstract available.
Anesthetics, Local ; Buprenorphine ; Peripheral Nerves

Opioid aberrant behavior is an emerging problem as strong opioid is increasingly used to alleviate cancer pain in patients with cancer. Although the treatment of opioid addiction and physical dependence for non-cancer pain is well known, few studies have been conducted with cancer patients, particularly in the Korean population. Presented here are ten cases of cancer patients who were physically dependent on strong opioid and successfully treated with a partial mu-opioid receptor agonist, buprenorphine. This is the first report showing the efficacy of transdermal buprenorphine as a treatment for physical dependence on opioid medication in cancer patients.
Analgesics, Opioid ; Buprenorphine* ; Humans ; Opioid-Related Disorders

OBJECTIVES: The purpose of this study was to develop and cross-culturally validate the Korean version of SMArtphone's uSability Heuristics (K-SMASH). METHODS: In the study, it was used the adaptation process consisted of five stages, namely, translation, synthesis, back translation, expert committee review, and pretesting. In the pretesting stage, a mobile application, using the prefinal K-SMASH, was evaluated for the severity of usability problems by three experts in computer science and informatics. Each participant completed the evaluation and was interviewed about their understanding, interpretation, and opinion of the cultural relevance of the prefinal K-SMASH. Next, we reviewed the differences in the experts’ opinions and the questionnaire results. RESULTS: Twelve SMASH items, words and sentences, were translated, back translated, and revised, considering the conceptual meaning in the context of the Korean culture, by experts in various fields, including a Korean linguist and a bilingual translator, through the first stage to the fourth stage. In the pretesting stage, the results showed no major differences among the severity ratings of participants. Furthermore, all participants answered that there were no critical discrepancies or inconsistencies with the cultural relevance of the prefinal K-SMASH. CONCLUSIONS: The results of the study provide preliminary evidence that the modified K-SMASH can be used for heuristic evaluation, one of the usability tests, when developing applications in Korea.
Buprenorphine ; Evaluation Studies as Topic ; Heuristics* ; Informatics ; Korea ; Mobile Applications ; Smartphone

AIMTo simulate the inhalation of the C21H27NO and C29H41NO4 molecules, the effective components of methadone and buprenorphine, into carbon nanotubes, and discuss the feasibility of the loading of methadone and buprenorphine into carbon nanotubes.

METHODSThe MM + force-field based molecular dynamics (MD) method uas used.

RESULTSThe ends-opened carbon nanotubes with diameter larger than 1 or 1.25 nm can initiatively inhale the C21H27 NO or C29H41NO4 molecule, and both two molecules have higher potential energy at the open ends of the carbon tubes than that at the middle of the tubes; the present single-walled nanotubes are very suitable for the loading of methadone and buprenorphine.

CONCLUSIONIt is possible to make sustained-release detoxification agents with methadone- or buprenorphine-loaded carbon nanotubes.

Buprenorphine ; chemistry ; Computer Simulation ; Methadone ; chemistry ; Models, Molecular ; Molecular Structure ; Nanotubes, Carbon ; chemistry ; Narcotic Antagonists ; chemistry

Adult ; Buprenorphine ; Female ; Humans ; Male ; Middle Aged ; Narcotic Antagonists ; Narcotics ; Opioid-Related Disorders ; mortality ; Singapore ; epidemiology

BACKGROUND: Buprenorphine is more potent and has less side effects than morphine. Therefore it can be used instead of morphine in cancer or postoperative pain contol. The aim of this study was to find an effective low dose of buprenorphine in epidural administration for pain control after obstetric-gynecologic surgery. METHODS: Epidural catheters were placed at L2-3 or L3-4 epidural space in all groups. Sixty nine patients were randomized to three epidural infusion group M, B1 and B2. Each group was 23. Group M: 3 mg morphine with 0.5% bupivacaine 10 ml as bolus, morphine 7 mg in 0.125% bupivacaine 100 ml in infusor; group B1: 0.068 mg buprenorphine with 0.5% bupivacaine 10 ml as bolus, buprenorphine 0.17 mg in 0.125% bupivacaine 100 ml in infusor; group B2: 0.11 mg buprenorphine with 0.5% bupivacaine 10ml as bolus, buprenorphine 0.24 mg in 0.125% bupivacaine 100 ml in infusor. Pain score, side effects and frequency of adjuvant analgesics were recorded at postoperative 1, 2, 6, 12, 24 and 48 hours. RESULTS: There was statistically significant difference of pain score at postoperative 1, 2 and 12 hrs in group B1 (p<0.05). Frequency of adjuvant analgesic was significantly increased in group B1. But there was no significant difference between group M and B2 in pain score. CONCLUSIONS: Our results suggest that buprenorphine 0.11 mg as bolus and 0.24 mg for 2 days are the optimal dose in continuous epidural administration for postoperative pain contol.
Analgesics ; Bupivacaine ; Buprenorphine* ; Catheters ; Epidural Space ; Humans ; Infusion Pumps ; Morphine ; Pain, Postoperative*

PURPOSE: To translate and culturally adapt a Korean version of the Neck Disability Index (NDI), as well as to validate its use in Korean patient. MATERIALS AND METHODS: The NDI was linguistically translated into Korean and the prefinal version was assessed and modified by a pilot study. The Korean version was tested on 60 patients with degenerative cervical spine disease to verify the reliability and validity. The test-retest reliability, internal consistency, concurrent validity, and construct validity were examined by a comparison with the VAS and SF-36. RESULTS: The intraclass correlation coefficient of test-retest reliability was 0.927. The reliability estimated by the internal consistency reached a Cronbach's alpha of 0.82. The correlation of the NDI with VAS was r=0.489 (p=0.002) and correlation between NDI and SF-36 was r=-0.44 (p<0.01). The physical health component score of SF-36 showed a high correlation with the NDI as well as a high correlation between VAS and mental health component scores of SF-36. CONCLUSION: The Korean version of the NDI is a reliable and valid instrument for measuring the disability in Korean patient with cervical problems and can be useful in future clinical studies in Korea.
Buprenorphine ; Humans ; Korea ; Mental Health ; Neck ; Pilot Projects ; Reproducibility of Results ; Spine

BACKGROUND: The transversus abdominis plane (TAP) block is an effective technique to block the thoracolumbar nerves innervating the anterolateral abdominal wall. This study was conducted to evaluate the analgesic efficacy and opioid consumption with the use of perineural buprenorphine or dexamethasone in TAP blocks after unilateral inguinal hernioplasties. METHODS: This prospective, randomized, double-blinded, placebo-controlled study enrolled 93 patients scheduled for unilateral inguinal hernioplasty, followed by an ultrasound-guided TAP block. The participants were randomized into 3 groups (31 patients each). Group L received 20 ml 0.25% levobupivacaine + 1 ml normal saline (NS); group LB, 20 ml 0.25% levobupivacaine + 0.3 mg (1 ml) buprenorphine; and group LD, 20 ml 0.25% levobupivacaine + 4 mg (1 ml) dexamethasone. The patients were observed postoperatively for 24 h for first rescue analgesic requirement, total rescue analgesic consumption, and pain scores on the numeric rating scale (NRS). RESULTS: The time to first rescue analgesic requirement was significantly longer in Group LB than in groups LD and L (688.87 ± 36.11 min, 601.45 ± 39.85 min, and 383.06 ± 36.21 min, respectively; P < 0.001). The mean total tramadol consumption in the first 24 h was the lowest in group LB (P < 0.001, L vs. LB / LD). Groups LB and LD displayed significantly lower NRS scores than group L (P < 0.001 both). CONCLUSIONS: Levobupivacaine with perineural buprenorphine in a TAP block after unilateral open inguinal hernioplasty facilitates prolonged analgesia and reduced requirement for rescue analgesics compared to perineural dexamethasone, without significant side effects.
Abdominal Wall ; Analgesia ; Analgesics ; Buprenorphine ; Dexamethasone ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Prospective Studies ; Tramadol ; Ultrasonography