Background: Our institution conducted a medication use evaluation of a novel sublingual opioid for use as an analgesic in the perioperative setting for a wide variety of surgical procedures to compare perioperative opioid utilization and recovery times between two different opioid dosing protocols.
Method and Materials: Patients undergoing a surgical procedure requiring opioidlevel analgesia were dosed sublingually with a sufentanil sublingual tablet 30 mcg in place of a standard dose of intravenous opioid (fentanyl, hydromorphone, or morphine) typically used for the procedure. The total dose of intraoperative and postoperative morphine milligram equivalents was calculated as well as the time in the recovery unit.
Results: Overall, 140 patients were dosed perioperatively with the sublingual sufentanil tablet from June 2019 to March 2020 and compared to 158 matched control patients undergoing similar surgeries with the same surgeons over a similar time period. Dosing of the tablet was either just prior to induction or intraoperatively in 137/140 of the patients, whereas 3 patients received a dose only in the recovery unit. The majority (90%) of patients required only a single tablet, while 14 patients required one additional dose in the recovery unit. The sufentanil sublingual tablet reduced opioid dosing requirements in the recovery unit by greater than 50% (p<0.001) compared to traditional intraoperative intravenous opioid dosing and resulted in an overall decrease in recovery discharge time by 14 min (p<0.001).
Conclusion: Perioperative sufentanil sublingual tablet administration can provide enhanced recovery compared to standard intravenous opioid administration.
Cassavaugh Koth M, Hogan Shannon M, Senska James C and Cady Mark D