Sublingual buprenorphine: A feasible alternative for treating breakthrough chronic pain

Nair, Abhijit; Mantha, Srinivasa Shyam Prasad; Kumar, Kodisharapu Praveen; Rayani, Basanth Kumar

doi:10.4103/ijpc.ijpc_41_19

Cited by 5 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“… 20 21 SL buprenorphine is an easy, non-invasive route of administration of a potent analgesic. 22 23 In the immediate postoperative period, the patients might either find it inconvenient to swallow or are not allowed orally immediately. 24 25 The bioavailability of SL buprenorphine appears to be comparable to that of IV morphine because of equianalgesic efficacy.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled study to compare analgesic efficacy of sublingual buprenorphine and intravenous tramadol in patients undergoing mastectomy

Nair

Dokku

Mantha

et al. 2023

Medical Gas Research

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Sublingual (SL) buprenorphine is approved for managing acute postoperative pain, characterized by easy administration, good pain relief and good patient compliance. We hypothesized that SL buprenorphine would be a better perioperative analgesic compared to intravenous (IV) opioids like tramadol in patients undergoing mastectomy surgery for breast cancer. After institutional ethics committee approval, we randomized 60 patients with breast cancer into 2 groups. In buprenorphine group, patients received 200 μg of SL buprenorphine thrice daily and in tramadol group patients received 100 mg of IV tramadol thrice daily. The analgesic efficacy of SL buprenorphine was comparable to that of IV tramadol. Visual Analogue Scale scores had no significant difference between the two groups at various time frames (0, 1, 3, 6, 12, 18 and 24 hours) at rest and movement except at 0 and 3 hours during movement when the score was lower in the tramadol group than the buprenorphine group. Four patients in the buprenorphine group received rescue analgesic (IV morphine 3 mg). Analgesic efficacy of SL buprenorphine appears comparable to IV tramadol for managing postoperative pain after mastectomy. SL buprenorphine can be administered sublingually, which is an advantage.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled study to compare analgesic efficacy of sublingual buprenorphine and intravenous tramadol in patients undergoing mastectomy

Nair

Dokku

Mantha

et al. 2023

Medical Gas Research

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“…By developing in cells that are activated in areas of damaged tissue, COX-2 enzymes help to regulate the pathological process and promote the healing and repair of harmed cells. 7 Additionally, there are two types of non-steroidal anti-inflammatory drugs (NSAIDs): selective and nonselective. These were developed based on how well they inhibited COX enzymes.…”

Section: Original Articlementioning

confidence: 99%

Efficacy of Celecoxib and Naproxen Sodium After Non-Surgical Extraction of Permanent Teeth: A Randomized Control Study

Nida Fatima,

Khalid Mahmood Siddiqui,

Baig

et al. 2024

Ann Pak Inst Med Sci

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Objective: To compare the level of pain relief that two NSAID salts offer following a simple closed tooth extraction technique, as well as to assess patient adherence to the prescribed dosage schedule. Methodology: This Randomized Control Design study was conducted at Islamabad medical & dental college, from 2018-2019. 150 patients made up the sample, who were split into two equal groups using a computerized lottery system: the experimental group and the control group. Following tooth extraction under local anesthesia, participants in the experimental group were told to take one 200 mg tablet of celecoxib orally for two days, while the control group was administered two 550 mg tablets of Naproxen Sodium orally twice a day. The standard Visual Analogue Scale (VAS) was used to assess post-extraction pain after 24 and 48 hours. Patients' adherence was verified by having them fill out a Performa form by phone call after 48 hours. After collection of Data, analysis was done with the help of SPSS version 21.0. Results: After tooth extraction, both medications were similarly effective in reducing pain, although participants adhered to the OD dose of celecoxib substantially more than the BD dose of naproxen sodium. Conclusion: There was statistically insignificant difference in pain relief provided by Celecoxib and Naproxen Sodium after 24 and 48 hours of single tooth extraction.

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“…Considering these multiple neurophysiological properties, buprenorphine may be used in opioid addiction; indeed, a strong agonist (such as heroin) can be displaced by buprenorphine thanks to its high affinity [ 135 , 136 , 137 , 138 ]. The oral bioavailability of buprenorphine is very low and highly variable [ 100 ]; buccal film and sublingual tablets are used to treat breakthrough pain (BTP) [ 140 ], while a transdermal patch is used for chronic pain relief [ 135 ]. Conversely, in perioperative settings, subdermal or subcutaneous implants and intravenous (IV) or intramuscular (IM) injections are frequently used [ 135 , 141 ].…”

Section: The Pharmacological Approachmentioning

confidence: 99%

Pharmacological Treatments and Therapeutic Drug Monitoring in Patients with Chronic Pain

De Rosa,

Giannatiempo,

Charlier

et al. 2023

Pharmaceutics

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Pain is an unpleasant sensory and emotional experience that affects every aspect of a patient's life and which may be treated through different pharmacological and non-pharmacological approaches. Analgesics are the drugs most commonly used to treat pain, and in specific situations, the use of opioids may be considered with caution. These drugs, in fact, do not always induce optimal analgesia in patients, and several problems are associated with their use. The purpose of this narrative review is to describe the pharmacological approaches currently used for the management of chronic pain. We review several aspects, from the pain-scale-based methods currently available to assess the type and intensity of pain, to the most frequently administered drugs (non-narcotic analgesics and narcotic analgesics), whose pharmacological characteristics are briefly reported. Overall, we attempt to provide an overview of different pharmacological treatments while also illustrating the relevant guidelines and indications. We then report the strategies that may be used to reduce problems related to opioid use. Specifically, we focus our attention on therapeutic drug monitoring (TDM), a tool that could help clinicians select the most suitable drug and dose to be used for each patient. The actual potential of using TDM to optimize and personalize opioid-based pain treatments is finally discussed based on recent scientific reports.

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Sublingual buprenorphine: A feasible alternative for treating breakthrough chronic pain

Cited by 5 publications

References 6 publications

A randomized controlled study to compare analgesic efficacy of sublingual buprenorphine and intravenous tramadol in patients undergoing mastectomy

A randomized controlled study to compare analgesic efficacy of sublingual buprenorphine and intravenous tramadol in patients undergoing mastectomy

Efficacy of Celecoxib and Naproxen Sodium After Non-Surgical Extraction of Permanent Teeth: A Randomized Control Study

Pharmacological Treatments and Therapeutic Drug Monitoring in Patients with Chronic Pain

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