Pharmacokinetics and pharmacodynamics of sublingual sufentanil for postoperative pain management

Donk, Tine van de; Ward, Stephen; Langford, R. M.; Dahan, Albert

doi:10.1111/anae.14132

Cited by 50 publications

(29 citation statements)

References 25 publications

(42 reference statements)

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“…Lipophilic, nonionized drug molecules have rapid uptake from sublingual tissues into the plasma as well as rapid uptake from the plasma to the l-opioid effector site in the central nervous system. It is mainly metabolized in the liver and enterocytes of the small intestines [26].…”

Section: Fig 4 Patient Satisfactionmentioning

confidence: 99%

Sufentanil Sublingual for Acute Post-Operative Pain: A Systematic Literature Review Focused on Pain Intensity, Adverse Events, and Patient Satisfaction

et al. 2020

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Context: Pain is commonly experienced among patients after surgical procedures. Clinical pain management after surgery is far from being successful. Patients may control postoperative pain by self-administration of intravenous opioids using devices designed for this purpose (patient-controlled analgesia or PCA). PCA devices have been developed including the sufentanil sublingual tablet system (SSTS). A systematic review of the use of SSTS for postoperative pain is needed to identify an alternative method of pain management. Objectives: To systematically review literature to establish the efficacy and the safety of PCA with SSTS used in the treatment of moderate-tosevere acute post-operative pain in a hospital setting.

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Section: Fig 4 Patient Satisfactionmentioning

confidence: 99%

Sufentanil Sublingual for Acute Post-Operative Pain: A Systematic Literature Review Focused on Pain Intensity, Adverse Events, and Patient Satisfaction

et al. 2020

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“… 1 – 6 The SSTS system is developed by AcelRx Pharmaceuticals (Redwood City, CA, USA) and is marketed in Europe as Zalviso™ by Grünenthal GmbH (Aachen, Germany). 5 The noninvasive hand-held SSTS is in fact a patient-controlled analgesia (PCA) device without the need for an intravenous (IV) catheter. The SSTS device holds a cartridge with 40 microtablets, each of which contains 15 μg sufentanil.…”

Section: Introductionmentioning

confidence: 99%

Sublingual sufentanil for postoperative pain relief: first clinical experiences

Meijer¹,

Cornelissen²,

Sie³

et al. 2018

JPR

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BackgroundThe sublingual sufentanil tablet system (SSTS) is a novel hand-held patient-controlled analgesia device developed for treatment of moderate-to-severe postoperative pain. Here we present the first results of its clinical use.MethodsAdult patients undergoing major surgery in five hospitals in the Netherlands received the SSTS for postoperative pain relief as part of multimodal pain management that further included paracetamol and a nonsteroidal anti-inflammatory drug (NSAID). The following variables were collected: postoperative pain scores using the 11-point numerical rating score (NRS) at rest, number of tablets used, occurrence of nausea, and patient satisfaction scores.ResultsWe included 280 patients in the study; the majority underwent laparoscopic abdominal (49%) or orthopedic (knee replacement) surgery (34%). The median NRS was 3.5 (interquartile range 2.3–4.0) on the day of surgery, 3.3 (2.3–4.0) on the first postoperative day, and 2.8 (2.0–4.0) on the second postoperative day; pain scores did not differ between surgery types. Mean number of tablets used was 19 (range 0–86). Nausea occurred in 34% of patients, more often in women (45% vs 19%). Overall satisfaction was high in 73% of patients. Satisfaction was correlated with pain relief (p<0.001) and inversely correlated with occurrence of nausea (p=0.01).DiscussionIn this data set obtained under real-life conditions we show that the SSTS effectively managed postoperative pain in abdominal and orthopedic surgeries. Future studies should determine patient populations that benefit most from the SSTS, assess the added values versus intravenous patient-controlled analgesia, and determine the pharmacoeconomics of the system.

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“…Previous studies have shown that dexmedetomidine has good analgesic sedative effect, and also significantly reduces the dose of anesthetic drugs required, reduces the duration of coma and shorten duration of mechanical ventilation ( 6 ). Sufentanil is an effective analgesic that rapidly crosses the blood-brain barrier and selectively activates central µ-opioid receptors ( 7 ), with a very high therapeutic index in clinical studies. There is no active metabolite, but there is a high degree of lipophilic property ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Application of dexmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients

Zhao

2020

Oncol Lett

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Application of dexmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients was studied. Colon cancer cases (n=176) admitted to Xiangya Hospital Central South University were selected into the study. They were divided into group A (n=92) and group B (n=84). In group A, patients underwent surgery anesthesia with dexmedetomidine combined with sufentanil. In group B, patients underwent surgery anesthesia only with sufentanil. The anesthesia induced intubation, operation time and incidence of postoperative adverse reaction of patients were compared between the two groups. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed and recorded before induction, before intubation and after intubation. Blood coagulation analyzer was used to detect four items of coagulation before and after operation. FACSCalibur flow cytometry was used to detect T lymphocyte subsets in peripheral blood of patients in the two groups. The pain scores (VAS) of patients in the two groups were measured and recorded after surgery at 4, 24 and 48 h. There was a difference in anesthesia induced intubation and operation time of patients in both groups (P<0.05). There were differences in HR, SBP and DBP of patients in both groups after intubation (P<0.05), in postoperative coagulation function (P<0.05), and in postoperative immune function of patients in both groups (P<0.05). The VAS scores of patients in both groups were different at different time-points after operation (P<0.05). There were differences in postoperative adverse reactions of patients in both groups (P<0.05). Dexmedetomidine combined with sufentanil is a viable anesthetic regimen for colon cancer resection. The coagulation function and immune function have certain improvement effect for patients.

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Pharmacokinetics and pharmacodynamics of sublingual sufentanil for postoperative pain management

Cited by 50 publications

References 25 publications

Sufentanil Sublingual for Acute Post-Operative Pain: A Systematic Literature Review Focused on Pain Intensity, Adverse Events, and Patient Satisfaction

Sufentanil Sublingual for Acute Post-Operative Pain: A Systematic Literature Review Focused on Pain Intensity, Adverse Events, and Patient Satisfaction

Sublingual sufentanil for postoperative pain relief: first clinical experiences

Application of dexmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients

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