Sublingual Sufentanil Tablet System (SSTS-Zalviso®) for Postoperative Analgesia after Orthopedic Surgery: A Retrospective Study

Abstract

Background: The aim of this study is to compare sublingual sufentanil and the administration device for its delivery (SSST-Zalviso®) with the traditional strategies used for the control of postoperative pain to establish if there is an actual benefit for the patient and healthcare personnel. Materials and Methods: A retrospective study was conducted to compare the efficacy of SSTS in the management of postoperative pain after orthopedic surgery between October 2018 and June 2020. We analyzed 50 patients who underwent a total knee arthroplasty (TKA). The control group consisted of 21 patients who underwent TKA and during the hospitalized recovery received a continuous femoral nerve block (cFNB). The statistical study was conducted with a level of significance p = 0.05 using “U” test, Mann−Whitney, to verify if patients had a better control of pain and fewer calls for rescue analgesia. Results: Patients involved in the study showed a significant reduction in pain intensity with the use of SSTS in the 24 h following surgery (p = 0.0568), also a drastic drop of the calls for rescue analgesia (p < 0.0001) reduces the number of calls for its control. Conclusions: This study demonstrates how SSTS might reduce pain intensity in the first 24 h after surgery and reduce the number of calls for its control, indicating better analgesic coverage and implying reduced interventions from healthcare personnel. This could allow a redistribution of resources and a reduction in the use of analgesic drugs in wards where the SSTS is used.

Keywords: continuous femoral nerve block; postoperative pain; retrospective study; sublingual sufentanil tablet system (SSTS–Zalviso®); total knee arthroplasty.

Figure 1

The Zalviso^® system consists of a disposable dispenser tip (a) and dispenser cap (b); a cartridge of Sufentanil sublingual 15 mcg tablets in a disposable bar-coded cartridge (c); a reusable handheld controller (d) and an authorized access card (e).

Figure 2

NRS were lower in the SSTS group compared to cFNB group at each time points measured with significant different in T1 (p = 0.008) *.

Figure 3

Boxplot analysis of pain control at 24 h, 48 h, and 72 h between the two groups. Horizontal line represents mean value, and the square box represents interquartile range.

Figure 4

Boxplot analysis rescue doses between the two groups. Horizontal line represents mean value and the square box represents interquartile range.

Figure 5

Boxplot analysis hospitalization between the two groups. Horizontal line represents mean value, and the square box represents interquartile range. (p = 0.039) *.