Sublingual Buprenorphine in Acute Pain Management: A Double-Blind Randomized Clinical Trial.

Author(s): Jalili M, Fathi M, Moradi-Lakeh M, Zehtabchi S

Affiliation(s): Emergency Department, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Publication date & source: 2011-11-23, Ann Emerg Med., [Epub ahead of print]

STUDY OBJECTIVE: We compare the efficacy and safety of sublingual buprenorphine versus intravenous morphine sulfate in emergency department adults with acute bone fracture. METHODS: Enrolled patients received buprenorphine 0.4 mg sublingually or morphine 5 mg intravenously in this double-blind, double-dummy, randomized controlled trial. Patients graded their pain with a standard 11-point numeric rating scale before medication administration and 30 and 60 minutes after, and we recorded adverse reactions. RESULTS: We analyzed 44 and 45 patients in the buprenorphine and morphine groups, respectively. Mean pain scores were similar at 30 minutes (5.0 versus 5.0; difference 0; 95% confidence interval -0.6 to 0.8) and at 60 minutes (2.2 versus 2.2; difference 0; 95% confidence interval -0.3 to 0.3). Adverse effects observed within 30 minutes were nausea (14% versus 12%), dizziness (14% versus 22%), and hypotension (4% versus 18%). CONCLUSION: For adults with acute fractures, buprenorphine 0.4 mg sublingually is as effective and safe as morphine 5 mg intravenously. Copyright (c) 2011. Published by Mosby, Inc.