Human T cell leukaemia virus associated lymphoproliferative disease: report of two cases in Nigeria.

not require further analgesia.Nausea or vomiting was a presenting feature of pancreatitis in 11 patients treated with pethidine and 15 with buprenorphine.This settled after analgesia in six and seven patients respectively.Only one patient receiving buprenorphine developed vomiting after administration of the drug.Specific questioning did not elicit any other side effects.Comnparisont of median pain scores before and after injection of pethidine and buprenorphine Pethidine Buprenorphine (n = 15) (n = 17) Linear analogue scale (range 0-10): Before injection 9 1 8.4 After injection 3 6 2-5 Difference 5 9 5 4 Ordered category scale (range 0-3): Before injection 3-0 2 9 After injection 1.1 1-1 Difference 1.9 1-6 Duration of pain relief (h) 9 5 9 2 CommentThis study shows that pethidine and buprenorphine provide comparable analgesia in acute pancreatitis.Although pethidine has some cost advantage ovet buprenorphine, it is a controlled and potentially addictive opiate.Potential addiction to narcotics in young adults presenting with recurrent episodes of pancreatitis, often secondary to alcohol abuse, is a cause for concern among clinicians treating this disease.Buprenorphine appears to have little potential for physical dependence; and may be preferred in such patients.Potential objec- tions to buprenorphine include its side effects of vomiting, dizziness, and respiratory depression, which are only partially reversed by naloxone.Respiratory depression was not seen in this study, but anxiety that it may occur may prevent the routine use of buprenorphine in acute pancreatitis, particularly in elderly patients with severe disease.