Cargando…

Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial

OBJECTIVES: Sublingual sufentanil is a novel opioid medication to treat moderate to severe pain postoperatively. This study's aim was to determine if a single dose of a sublingual sufentanil tablet (SST) is as efficacious as a single dose of intravenous (IV) fentanyl in readiness to discharge f...

Descripción completa

Detalles Bibliográficos
Autores principales: Berg, Aaron, Habeck, Jason, Strigenz, Michael, Pearson, Jonah, Kaizer, Alexander, Hutchins, Jacob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286986/
https://www.ncbi.nlm.nih.gov/pubmed/35844809
http://dx.doi.org/10.1155/2022/5237877
_version_ 1784748146162663424
author Berg, Aaron
Habeck, Jason
Strigenz, Michael
Pearson, Jonah
Kaizer, Alexander
Hutchins, Jacob
author_facet Berg, Aaron
Habeck, Jason
Strigenz, Michael
Pearson, Jonah
Kaizer, Alexander
Hutchins, Jacob
author_sort Berg, Aaron
collection PubMed
description OBJECTIVES: Sublingual sufentanil is a novel opioid medication to treat moderate to severe pain postoperatively. This study's aim was to determine if a single dose of a sublingual sufentanil tablet (SST) is as efficacious as a single dose of intravenous (IV) fentanyl in readiness to discharge from ambulatory surgery. METHODS: This was a two-arm, parallel group, randomized prospective outcomes study conducted at a single, free-standing ambulatory surgery center. Patients aged 18–80 undergoing general anesthesia who developed a postoperative pain score of ≥ 4 were enrolled and randomized to receive either 30 mcg SST or 50 mcg IV fentanyl. After their initial randomized dose, rescue IV fentanyl followed by oral oxycodone if needed. Recovery length of stay from arrival in the postanesthesia care unit until readiness to discharge criteria was met based on phase 2 discharge criteria. RESULTS: 75 patients were analyzed. Readiness to discharge from the recovery room was not significantly different between either group (IV fentanyl median 65 minutes; IQR 56–89; SST 73 min, IQR 58–89; p=0.903). There was no significant difference in the amount of morphine equivalents (MME) of rescue opioids needed (IV fentanyl median rescue MME of 22.5, IQR 13.1–23.4; SST median rescue MME of 15.0, IQR 7.5–30.0; p=0.742). The change in pain from PACU initially, and on discharge was not significantly different (IV fentanyl initial pain minus pain on discharge median 3, IQR 2–4; SST initial pain minus pain on discharge median 4, IQR 2–5.5; p=0.079). There was no difference in the six-item screener and the Overall Benefit of Analgesic Survey Score. Discussion. In conclusion, patients who received a sublingual sufentanil 30 mcg tablet had no significant differences in PACU length of stay or rescue analgesic usage when compared to intravenous fentanyl 50 mcg.
format Online
Article
Text
id pubmed-9286986
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-92869862022-07-16 Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial Berg, Aaron Habeck, Jason Strigenz, Michael Pearson, Jonah Kaizer, Alexander Hutchins, Jacob Anesthesiol Res Pract Research Article OBJECTIVES: Sublingual sufentanil is a novel opioid medication to treat moderate to severe pain postoperatively. This study's aim was to determine if a single dose of a sublingual sufentanil tablet (SST) is as efficacious as a single dose of intravenous (IV) fentanyl in readiness to discharge from ambulatory surgery. METHODS: This was a two-arm, parallel group, randomized prospective outcomes study conducted at a single, free-standing ambulatory surgery center. Patients aged 18–80 undergoing general anesthesia who developed a postoperative pain score of ≥ 4 were enrolled and randomized to receive either 30 mcg SST or 50 mcg IV fentanyl. After their initial randomized dose, rescue IV fentanyl followed by oral oxycodone if needed. Recovery length of stay from arrival in the postanesthesia care unit until readiness to discharge criteria was met based on phase 2 discharge criteria. RESULTS: 75 patients were analyzed. Readiness to discharge from the recovery room was not significantly different between either group (IV fentanyl median 65 minutes; IQR 56–89; SST 73 min, IQR 58–89; p=0.903). There was no significant difference in the amount of morphine equivalents (MME) of rescue opioids needed (IV fentanyl median rescue MME of 22.5, IQR 13.1–23.4; SST median rescue MME of 15.0, IQR 7.5–30.0; p=0.742). The change in pain from PACU initially, and on discharge was not significantly different (IV fentanyl initial pain minus pain on discharge median 3, IQR 2–4; SST initial pain minus pain on discharge median 4, IQR 2–5.5; p=0.079). There was no difference in the six-item screener and the Overall Benefit of Analgesic Survey Score. Discussion. In conclusion, patients who received a sublingual sufentanil 30 mcg tablet had no significant differences in PACU length of stay or rescue analgesic usage when compared to intravenous fentanyl 50 mcg. Hindawi 2022-07-08 /pmc/articles/PMC9286986/ /pubmed/35844809 http://dx.doi.org/10.1155/2022/5237877 Text en Copyright © 2022 Aaron Berg et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Berg, Aaron
Habeck, Jason
Strigenz, Michael
Pearson, Jonah
Kaizer, Alexander
Hutchins, Jacob
Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title_full Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title_fullStr Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title_full_unstemmed Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title_short Sublingual Sufentanil vs. Intravenous Fentanyl for the Treatment of Acute Postoperative Pain in the Ambulatory Surgery Center: A Randomized Clinical Trial
title_sort sublingual sufentanil vs. intravenous fentanyl for the treatment of acute postoperative pain in the ambulatory surgery center: a randomized clinical trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286986/
https://www.ncbi.nlm.nih.gov/pubmed/35844809
http://dx.doi.org/10.1155/2022/5237877
work_keys_str_mv AT bergaaron sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial
AT habeckjason sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial
AT strigenzmichael sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial
AT pearsonjonah sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial
AT kaizeralexander sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial
AT hutchinsjacob sublingualsufentanilvsintravenousfentanylforthetreatmentofacutepostoperativepainintheambulatorysurgerycenterarandomizedclinicaltrial