Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Jul-Aug;70(4):419-428.
doi: 10.1016/j.bjan.2020.04.004. Epub 2020 Jul 8.

[Transdermal buprenorphine for acute postoperative pain: a systematic review]

[Article in Portuguese]
Felipe Chiodini Machado  1 , Gilson Carone Neto  2 , Luisa Oliveira de Paiva  2 , Tamiris Cristina Soares  2 , Ricardo Kenithi Nakamura  2 , Leonardo de Freitas Nascimento  2 , Camila Sato Campana  2 , Lia Alves Martins Mota Lustosa  2 , Rachel Andrade Cortez  2 , Hazem Adel Ashmawi  2
Affiliations
Comparative Study

[Transdermal buprenorphine for acute postoperative pain: a systematic review]

[Article in Portuguese]
Felipe Chiodini Machado et al. Braz J Anesthesiol. 2020 Jul-Aug.

Abstract

Background and objectives: Postoperative pain is still a major concern in several surgical procedures. Multimodal analgesia is best for postoperative pain management; however, opioid therapy is still the main treatment for pain after surgical procedures. Transdermal buprenorphine is a partial μ-agonist opioid widely used for chronic pain syndromes, with limited evidence for acute postoperative pain. A systematic review of studies examining transdermal buprenorphine for acute pain management after surgery was conducted.

Contents: Data from PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL via EBSCOhost, and LILACS were reviewed, including randomized clinical trials that evaluated total postoperative pain, postoperative analgesic consumption, drug-related side effects and patient satisfaction with analgesia regimen. Data from nine studies (615 patients) were included in this review. Most studies initiated transdermal buprenorphine use 6 to 48 hours before surgery, maintaining use from 1 to 28 days after the procedure. Most studies showed lower or similar postoperative pain scores, postoperative analgesic consumption and patient satisfaction comparing buprenorphine to placebo, tramadol, celecoxib, flurbiprofen and parecoxib. The incidence of side effects varied between studies, with most showing no increase in drug-related side effects with buprenorphine use, except one study, which compared buprenorphine to oral tramadol, and one to transdermal fentanyl. However, most results were derived from evidence with an overall high or unclear risk of bias.

Conclusions: Although more studies are necessary, initial results show that transdermal buprenorphine seems to be an effective and safe opioid choice for management of acute postoperative pain.

Keywords: Acute pain; Administration, cutaneous; Administração, cutânea; Buprenorfina; Buprenorphine; Dor aguda; Dor pós‐operatória; Postoperative pain; Sistema transdérmico; Transdermal patch.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA flow diagram. From: Moher D, Liberati A, Tetzlaff J, Altman DG, the PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Med 6(7): e1000097.
Figure 2
Figure 2
Risk of bias summary.
See this image and copyright information in PMC

References

    1. Gerbershagen H.J., Aduckathil S., Van Wijck A.J.M., et al. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934–944. - PubMed
    1. Kehlet H., Jensen T.S., Woolf C.J. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–1625. - PubMed
    1. Chou R., Gordon D.B., De Leon-Casasola O.A., et al. Management of postoperative pain: a clinical practice guideline from the American pain society, the American society of regional anesthesia and pain medicine, and the American society of anesthesiologists’ committee on regional anesthesia, executive commi. J Pain. 2016;17:131–157. - PubMed
    1. Brennan T.J. Pathophysiology of postoperative pain. Pain. 2011;152:S33–S40. - PMC - PubMed
    1. Vadivelu N., Anwar M. Buprenorphine in postoperative pain management. Anesthesiol Clin. 2010;28:601–609. - PubMed

MeSH terms