Research Article
Sublingual Sufentanil Tablet System for Postoperative Pain Relief after Spinal Lumbar Neurosurgery. A Retrospective Comparison with IV Morphine Patient Controlled Analgesia
Dransart Christophe, De Bue Pascale,
Jamart Jacques, Mitchell John, Gustin
Thierry, Dubois Philippe E
Correspondence Address :
Dubois Philippe E
Anaesthesiology and Acute Pain department,
Universite catholique de Louvain
CHU UCL
Namur, site Godinne
Avenue Dr Gaston Therasse
1 , B-5530 Yvoir, Belgium
Email: phil.dubois@uclouvain.be
Received on: September 20, 2018, Accepted on: September 27, 2018, Published on: October 04, 2018
Citation: Dransart Christophe, De Bue Pascale, Jamart Jacques, Mitchell John, Gustin Thierry, Dubois Philippe E (2018). Sublingual Sufentanil
Tablet System for Postoperative Pain Relief after Spinal Lumbar Neurosurgery. A Retrospective Comparison with IV Morphine Patient
Controlled Analgesia
Copyright: 2018 Dubois Philippe E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: An enhanced and rapid recovery after surgery has become the new challenge to reduce postoperative complications and length of hospital stay. This retrospective study evaluated the benefits provided by the new sufentanil sublingual tablet system (SSTS) compared to patient controlled analgesia (PCA) with intravenous (IV) morphine in the specific context of spinal lumbar neurosurgery.
Method: We selected 80 patients undergoing 1-2 levels lumbar laminectomy and/or discectomy to evaluate the SSTS. A second group was retrospectively constituted with 80 patients having benefited from the same surgery with IV morphine PCA during the period just preceding the SSTS test period. All patients received similar intraoperative multimodal analgesia. In post anesthesia care unit, piritramide (SSTS group) or morphine (IV PCA group) was titrated intravenously to insure a pain score below 4/10 before PCA initiation.
The acute pain service evaluated on Day 1 and Day 2 the pain intensity (visual analogic score at rest and during mobilization) and opioid related side effects. Results were compared using Mann-Whitney-Wilcoxon test, p<0.05 was considered significant. Any comments of the health care personal were collected during the SSTS test.
Results: The mean uptake after 48 hours was 34.99 mg IV morphine and 18.60 sufentanil tablets. Except for Day 1 at rest, pain intensity evaluations were significantly different between both groups, in favor of the IV PCA. There was no significant difference in side effects between groups. Valuable technical and practical comments were collected from patients and nurses, and were discussed.
Conclusion: Despite a significant difference in postoperative pain scores, we demonstrated the overall satisfaction of the patients and the health care personal for the innovative system but some questions and problems were highlighted and would benefit from technical improvements, administrative refinements and further dedicated studies.