Sublingual buprenorphine for acute postoperative cancer pain: a retrospective study

Abstract

AbstractBackgroundSublingual buprenorphine is an atypical opioid that potentially has a wider safety profile than conventional opioids. However, there is a paucity of literature concerning its role in acute postoperative pain.AimTo describe the use of sublingual buprenorphine including efficacy and safety for the management of acute postoperative pain at a comprehensive cancer centre.MethodA retrospective study of sublingual buprenorphine analgesia after cancer surgery between 1 June 2015 to 31 October 2016. Outcome measures included pain scores (Verbal Numerical Rating Scale), dosage, oral morphine equivalent daily dose before treatment, adverse events, co‐analgesia, duration of treatment and length of stay. Patients were categorised as responders or non‐responders based on their response. Ethics approved by the Peter MacCallum Cancer Centre Expedited Ethics Review Committee (approval no. 18/59R).ResultsSixty‐six patients were included with a mean age of 62.8 years and 53% were male. Of those, 86.3% (55/66) were categorised as responders to sublingual buprenorphine treatment. Pain scores were significantly lower in responders compared to non‐responders after treatment 4.2 versus 7.3 (p < 0.05). Sublingual buprenorphine was well tolerated with a low adverse event frequency (10.6%), with nausea/vomiting reported most commonly. All patients were prescribed at least one co‐analgesic. The mean duration of treatment was 6.2 days and there was no difference in length of stay between groups.ConclusionAfter cancer surgery, patients can benefit from sublingual buprenorphine analgesia due to its safe adverse event profile and overall self‐reported efficacy. Further research is recommended to account for confounders including study in a larger cohort.