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. 2019 Jul 26:12:2313-2319.
doi: 10.2147/JPR.S214600. eCollection 2019.

Sufentanil Sublingual Tablet System (SSTS) for the management of postoperative pain after major abdominal and gynecological surgery within an ERAS protocol: an observational study

Stefano Turi  1 , Francesco Deni  1 , Gaetano Lombardi  1 , Marilena Marmiere  1 , Francesco Giuseppe Nisi  1 , Luigi Beretta  1
Affiliations

Sufentanil Sublingual Tablet System (SSTS) for the management of postoperative pain after major abdominal and gynecological surgery within an ERAS protocol: an observational study

Stefano Turi et al. J Pain Res. .

Abstract

Background: The Sufentanil Sublingual Tablet System (SSTS) is a new, pre-programmed, noninvasive, handheld system for patient-controlled analgesia (PCA) which may allow a faster postoperative recovery compared with standard PCA. The efficacy of SSTS in controlling pain after open abdominal surgery has already been documented. However, to our knowledge SSTS has never been investigated in patients undergoing major surgery within an Enhanced Recovery After Surgery (ERAS) protocol.

Methods: This observational, retrospective analysis included consecutive patients undergoing elective major abdominal and gynecological surgery. All patients received the SSTS device once they were fully awake and had a good control of pain at the end of the surgery. We analyzed changes in pain intensity according to the numerical rating scale (NRS) throughout the treatment as well as its duration, the number of administrations, and possible related adverse events. Patients were also interviewed to assess their quality of sleep and overall satisfaction with the SSTS device.

Results: The study included 308 patients. Compared to the first SSTS administration, pain intensity decreased from a median NRS of 6 to 0 at day 3, for an overall reduction of 79%. Results were already statistically significant at postoperative day 1 (p<0.01). Adverse reactions were observed in 62 patients, with nausea being the most frequent (12%), and in 93% of patients SSTS was discontinued because it was considered no longer necessary. Patient satisfaction was high, with 89% of them judging the device as "easy" or "very easy" to use.

Conclusions: Although the retrospective and observational nature of the study as well as the absence of a comparative group limits the strength of evidence, our results consider SSTS an effective and safe tool for the management of postoperative pain after major abdominal and gynecological surgery within an ERAS protocol.

Keywords: ERAS; PCA; SSTS; analgesia; postoperative.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Duration of Sufentanil Sublingual Tablet System (SSTS) treatment.
Figure 2
Figure 2
Mean (SD) pain intensity throughout Sufentanil Sublingual Tablet System (SSTS) treatment. T-1 represents the day before surgery, T0 the delivery of the device to the patient, V0 the first tablet administration.
Figure 3
Figure 3
Mean (SD) pain intensity at rest and upon movement throughout SSTS treatment. *p<0.01 compared to first administration (V0).
See this image and copyright information in PMC

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