Dilatation of radiation-induced esophageal strictures under sublingual buprenorphine analgesia: A pilot study

Background: Pain during dilatation of radiation strictures is a troublesome complaint. There is little information on sedation and analgesia during this procedure. We performed a pilot study to compare the analgesic efficacy of sublingual buprenorphine and intravenous pentazocin during dilatation of radiation-induced esophageal strictures. Methods: Thirty-one patients with esophageal cancer who had radiation-induced strictures were randomized to receive either buprenorphine 0.2 mg sublinguallly two hours before dilatation (n=17) or pentazocine 30 mg intravenously five minutes before dilatation (n=14). Dilatation was considered successful if it could be performed to 12 mm diameter or more. Pain experienced during dilatation was graded as mild, moderate or severe. Results: Sixteen patients in the buprenorphine group and 12 in the pentazocine group were dilated to >12 mm size (p=ns). Twelve and nine patients respectively in the two groups experienced mild or no pain; ten and six patients had minor side-effects (p=ns). Conclusion: Buprenorphine is useful for sedoanalgesia during dilatation of radiation-induced strictures of the esophagus.