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Buprenorphine hydrochloride, a new, potent, long-acting synthetic opiate analgesic, with partial agonist-antagonist activity, was administered intravenously to two groups of patients in an intensive care unit. Arterial blood was drawn for blood gas analysis before (control) and at regular intervals after drug administration, to determine the effects of intravenous buprenorphine on respiration in critically ill patients, each acting as his or her own control. Intravenous buprenorphine 0,4 mg (group I -- 10 patients) caused a significant reduction in mean respiration rate and an increase in mean PaCO2, but did not alter heart rate, PaO2 or base excess values. Intravenous buprenorphine 0,2 mg (group II -- 10 patients) was associated with a less significant reduction in the rate of breathing and elevation of PaCO2. Both 0,4 mg and 0,2 mg buprenorphine produced effective relief of pain, sedation, and reduction in restlessness, and allayed anxiety. Our results suggest that intravenous buprenorphine 0,2 mg can be safely recommended for the prolonged relief of postoperative pain in adults.

The use of excessive amounts of heparin to anticoagulate blood samples for pH and blood gas analysis leads to erroneously low PCO2 results, whereas pH and PO2 are relatively unaffected. Derived base deficit values accordingly will be high. Dilution is seldom less than 6% but may exceed 40%, particularly when sampling fron neonates. Sodium citrate and Heller-Paul oxalate solutions were found to be suitable alternatives to heparin, whereas EDTA was not.

The concentrations of several essential trace elements in various intravenous fluids commonly used in South Africa were measured. With the exception of 4% human serum albumin and fresh freeze-dried plasma (FDP), intravenous fluids contained minimal amounts of essential trace elements. Although FDP contained significant quantities of zinc, copper, iron and chromium, the common practice of giving patients on total parenteral nutrition 1-2 units per week will not fulfil the recommended daily requirements. Additional trace element supplements should therefore be given intravenously to these patients.