Comparison of the respiratory effects of intravenous buprenorphine and fentanyl in humans and rats

Dahan, Albert; Yassen, Ashraf; Bijl, Hans; Romberg, Raymonda; Sarton, Elise; Teppema, Luc J.; Olofsen, Erik; Danhof, Meindert

doi:10.1093/bja/aei145

Cited by 274 publications

(192 citation statements)

References 19 publications

Supporting

Mentioning

182

Contrasting

Unclassified

Order By: Relevance

“…Contrary to earlier concerns, there was a ceiling effect found for respiratory depression but not for analgesia (Dahan et al, 2005 Level III-2; Dahan et al, 2006 Level III-2). The risk of respiratory depression is low compared with morphine, methadone, hydromorphone and fentanyl, even in the doses used for the treatment of opioid addiction, as long as concurrent sedative medications are not given (Kress, 2009).…”

Section: Chaptercontrasting

confidence: 97%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

show abstract

Section: Chaptercontrasting

confidence: 97%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…Buprenorphine is a partial m-opioid receptor agonist. At clinical doses, it exhibits full-dose-dependent analgesia but a plateau in respiratory depression (11,13,14). Neuropathic pain is associated with loss of pertussis toxin-sensitive G-protein activity (15) on which the analgesic action of pure m-opioids, such as morphine, depends.…”

mentioning

confidence: 99%

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Simpson

Wlodarczyk

2016

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVETo evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). RESEARCH DESIGN AND METHODSThis multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 mg/h) or placebo patches. The dose was titrated to effect to a maximum of 40 mg/h. Paracetamol was available as rescue analgesia. The severity of pain and other symptoms of DPNP were assessed daily in a patient diary and at clinic visits. RESULTSOne hundred eight-six patients were enrolled, with 93 randomized to either buprenorphine or placebo. A high proportion of patients did not complete the study (buprenorphine 37 of 93, placebo 24 of 93). The main reason for premature withdrawal in the buprenorphine group was adverse events commonly due to untreated nausea and/or vomiting. Among the per-protocol population, more patients in the buprenorphine group (86.3%) experienced a 30% reduction in average versus baseline pain at week 12 than those in the placebo group (56.6%, P < 0.001). A nonsignificant trend favored the buprenorphine group within the intention-to-treat analysis of the same end point (51.7% vs. 41.3%, P = 0.175). CONCLUSIONSTransdermal buprenorphine, when tolerated, is an effective therapy for DPNP and provides another option to manage this challenging painful condition. Nausea and constipation need to be managed proactively to optimize treatment outcomes.

show abstract

“…

0,1,2,3,4,5,8,9,10,11,12,18 and 24 hrs among the three groups were statistically not significant. The increase observed at 6 and 7 hrs in tramadol and fentanyl groups compared with buprenorphine group was statistically significant which can be explained based on shorter duration of action of tramadol and fentanyl leading to wearing of the analgesic effect.

…”

mentioning

confidence: 79%

“…It is a combined constellation of several unpleasant sensory, emotional and mental experiences precipitated by the surgical trauma and associated with autonomic, endocrine-metabolic, physiological and behavioral responses 2 . Despite the advances in the knowledge of mechanism of the pathophysiology of pain, the pharmacology of analgesics and the development of more effective techniques, patients continue to experience considerable pain after surgery 3 . Post operative pain has drawn the attention of a large number of workers as it is one of the most distressing outcomes of any surgery, and its ablation brings a great relief to the suffering patient 4 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Post Operative Analgesia with Epidural Tramadol, Fentanyl And Buprenorphine

Naik¹,

Rao²,

Naik³

2017

IOSR JDMS

View full text Add to dashboard Cite

show abstract

Comparison of the respiratory effects of intravenous buprenorphine and fentanyl in humans and rats

Abstract: Our data confirm a ceiling effect of buprenorphine but not fentanyl with respect to respiratory depression.

Cited by 274 publications

References 19 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Efficacy of Post Operative Analgesia with Epidural Tramadol, Fentanyl And Buprenorphine

Contact Info

Product

Resources

About