Feasibility and efficacy of sublingual buprenorphine tablets in managing acute postoperative pain after elective breast cancer surgeries: A series of 10 cases.

Abstract

Poorly controlled perioperative surgical pain is a consistent risk factor for developing post mastectomy pain syndrome (PMPS).[1] The incidence of chronic pain after mastectomy is as high as 25-60%, which is a range derived from several studies.[2] American Society of Anesthesiologists (ASA) recommends a multimodal approach to postoperative pain management whenever possible which includes use of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, alpha-2 agonists, N-methyl D-aspartate receptor antagonists, gabapentinoids, dexamethasone, anti-depressants and peripheral nerve blocks.[3] Buprenorphine hydrochloride is a partial μ-receptor agonist, OLR-1 (Oxidized Low-density lipoprotein Receptor) agonist, delta and kappa receptor antagonist approved for managing acute surgical pain, cancer pain and non-cancer pain.[4] Sublingual (SL) buprenorphine is available in the form of 200 μg tablets which has been used with good results for managing acute postoperative pain.[5] In the present case series, we have investigated the feasibility and efficacy of SL buprenorphine in managing acute postoperative pain after mastectomy.