Buprenorphine for acute post-surgical pain: A systematic review and meta-analysis

Abstract

Our study was designed to evaluate the efficacy of buprenorphine for the management of acute post-surgical pain reported in published studies in the years 2015–2022. Comprehensive research was performed by using online resources like PUBMED and the Wiley Library database to gather the relevant literature. Two authors were assigned to independently collect the information. Cochran's Q-test and I square statistic were used to determine the heterogeneity across the studies. Publication bias was estimated by using the Egger regression analysis and found to be significantly present once the P value <0.05. In this review, 15 studies were included. The pooled ratio of pain reduction after 12 hours of surgery was reported as 11.2% with 97% heterogeneity. Day one shows 5.9 reductions in pain with 98% heterogeneity. The 3% more pain was reduced on day 2. The day 3 pooled pain reduction score was observed as 1.9%. The overall pool prevalence of pain reduction was noted as 6.2% at different time duration with significant heterogeneity of 100%. Buprenorphine transdermal and sublingual both have significant pain relief scores. The analgesic drug consumption was reduced at the end of the follow-up duration.

Efficacy of postoperative buprenorphine in the first 12 hours after surgery

“…In summary, the promising results of transdermal or sublingual buprenorphine shown by Albaqami et al . [ 1 ] should be confirmed by a reanalysis in the random-effects model. However, the TSAs suggest that more research is needed to determine the role of buprenorphine in reducing acute postsurgical pain beyond the first 12 hours.…”

“…Albaqami et al . [ 1 ] are to be congratulated for their work suggesting that transdermal buprenorphine and sublingual buprenorphine have significant effects on pain relief, reducing also analgesic drug consumption. The effects of buprenorphine in the postoperative period seem promising as shown also by a randomized controlled study where increasing dosages of buprenorphine improved analgesia while not being associated with an increased incidence of side effects.…”

“…Indeed, the fixed-effects models should not be used when there is I 2 as in the meta-analysis by Albaqami et al . [ 1 ] where the heterogeneity was high both overall (I 2 = 98%) and in the subgroup analyses (ranging from 97 to 99%). In such cases, it is strongly recommended to use a random-effects model, which better balances the weights of the included studies.…”