Intraoperative measurement of the bile flow resistance in the terminal portion of the common bile duct and its clinical significance in biliary surgery

The effect of buprenorphine and oxycodone on the intracholedochal passage pressure

The effect of i.v. buprenorphine (0.3 mg) and oxycodone (10mg) on intracholedochal passage pressure were studied in 20 patients who had undergone surgery of the common biliary tract, prior to the extraction of an indwelling T tube. Informed consent was obtained from all patients, each of who was given buprenorphine or oxycodone in random order. The intracholedochal passage pressure was measured from the T tube perfused with continuous saline infusion (55 ml/h). Both analgesics significantly (P less than 0.01) increased the intracholedochal passage pressure after 5 min, with an equal peak increase of about 1.5 kPa at about 7 min. The pressure decline was rapid and similar in both groups: 20 min after administration of the test drug only about 40% of the maximum elevation caused by either drug remained. Thereafter, a slower fall towards the baseline was recorded after both drugs during the remaining 45 min of the study period. The results indicate that buprenorphine can be used with the same indications and precautions as other narcotics for postoperative pain relief in patients who have undergone surgery of the biliary tract.