Patients' perspective in postoperative pain management: role of sufentanil sublingual tablet system in major orthopedic surgery

Background and Aims: Inadequate post-operative pain management is one of the most common complain after major orthopedic surgery. Limits of iv- PCA have been identified in programming and patients' errors, invasive access, and impairment of mobility. The aim of this study was to evaluate patient' perspective into sufentanil sublingual tablet system Zalviso®(SSTS) evaluation for post-operative pain management after orthopedic surgery. Methods: Adults, who had undergone major orthopedic surgery, with expected postoperative pain ≥4 on a 11-point numeric rating scale, received SSTS 15mcg, with a 20-minute lockout interval, as requested for pain, over the 72-hour study period. Datawere collected at baseline (T0) and 3, 6, 12, 24, 36, 48, 60, 72 hours after surgery. The primary endpoint was the Patient Global Assessment (PGA) on a 5-point categorical scale. Secondary endpointswere analgesic efficacy, need for supplemental rescue doses, and sleep pain interference. Results: 36 patientswere enrolled. 97.2%of patients evaluated the treatment as excellent or very good on PGA. No patients discontinued due to inadequate analgesia or adverse events. Required SSTS doses ranged from 5 to 48 in 72 hours. SSTS doses were significantly higher in TKA (29.8), compared with THA (22). Mean required SSTS doses in different surgeries are shown in Figure 1. Rescue doses were needed in 5.5% of SSTS patients. Quality of sleep was good or very good in 86.1% of patients on the same day of surgery. Conclusions: SSTS was well accepted by patients undergoing major orthopedic surgery and resulted in effective management of moderate-to-severe acute postoperative pain.