Patient-controlled sublingual sufentanil tablet system versus intravenous opioid analgesia for postoperative pain management after lumbar spinal fusion surgery,European Spine Journal

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Patient-controlled sublingual sufentanil tablet system versus intravenous opioid analgesia for postoperative pain management after lumbar spinal fusion surgery
European Spine Journal ( IF 2.6 ) Pub Date : 2022-12-06 , DOI: 10.1007/s00586-022-07462-x
Chris Lindemann ₁ , Patrick Strube ₁ , Christian Fisahn ₁ , Mirco Sgroi ₂ , Daniel Dornacher ₂ , Timo Zippelius ₂

Affiliation

Purpose

This retrospective cohort study investigated the efficacy of a sublingual sufentanil tablet system (SSTS) in comparison to intravenous patient-controlled analgesia (IV-PCA) with piritramide for the management of postoperative pain following lumbar spinal fusion surgery.

Methods

This was a retrospective analysis of patients undergoing single- or two-level lumbar spinal fusion surgery and receiving the SSTS or IV-PCA for postoperative pain relief as part of multimodal pain management that included IV paracetamol and oral metamizole. The following variables were collected: postoperative pain intensity and frequency scores using the numerical rating scale (NRS), hospital anxiety and depression scale (HADS), occurrence of nausea, postoperative mobilization, and patient satisfaction (MacNab criteria).

Results

Sixty-four patients were included. Those receiving the SSTS (n = 30) had significantly lower pain intensities on the operative day (NRS: 4.0, CI: 3.6–4.3 vs. 4.5, CI: 4.2–4.9; p < 0.05) and one day postoperatively (NRS: 3.4, CI: 3.1–3.8 vs. 3.9 CI: 3.6–4.3; p < 0.05) compared to patients receiving IV-PCA (n = 34). No differences were observed on postoperative days 2 to 5. SSTS patients experienced more nausea than IV-PCA patients (p = 0.027). Moreover, SSTS patients had a higher percentage of early mobilization following surgery than IV-PCA patients (p = 0.040). Regarding patient satisfaction, no significant differences were seen between the groups.

Conclusion

The SSTS is a potentially advantageous alternative to opioid IV-PCA for use within a multimodal approach to managing postoperative pain after lumbar fusion surgery. Furthermore, the potentially higher emetic effect of SSTS should be considered, and the patient should be able to perform the application.

中文翻译：

患者自控舌下舒芬太尼片系统与静脉阿片类药物镇痛在腰椎融合手术术后疼痛管理中的比较

目的

这项回顾性队列研究调查了舌下含服舒芬太尼片剂系统 (SSTS) 与静脉内患者自控镇痛 (IV-PCA) 和吡利曲胺 (piritramide) 在腰椎融合手术术后疼痛管理中的疗效。

方法

这是对接受单节段或双节段腰椎融合手术并接受 SSTS 或 IV-PCA 以缓解术后疼痛的患者的回顾性分析，作为多模式疼痛管理的一部分，包括静脉注射扑热息痛和口服安乃近。收集了以下变量：使用数字评定量表 (NRS) 的术后疼痛强度和频率评分、医院焦虑和抑郁量表 (HADS)、恶心的发生、术后活动和患者满意度（MacNab 标准）。

结果

包括 64 名患者。接受 SSTS 的患者 ( n = 30) 在手术当天 (NRS: 4.0, CI: 3.6–4.3 vs. 4.5, CI: 4.2–4.9; p < 0.05) 和术后一天 (NRS: 3.4)的疼痛强度显着降低, CI: 3.1–3.8 vs. 3.9 CI: 3.6–4.3; p < 0.05) 与接受 IV-PCA 的患者 ( n = 34) 相比。术后第 2 至 5 天未观察到差异。SSTS 患者比 IV-PCA 患者出现更多恶心 ( p = 0.027)。此外，SSTS 患者术后早期活动的百分比高于 IV-PCA 患者 ( p = 0.040)。关于患者满意度，两组之间没有显着差异。