Efficacy of Intravenous Buprenorphine for Acute Pain in Critically Ill Patients in a Medical Intensive Care Unit.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY

Journal of pharmacy practice Pub Date : 2025-09-30 DOI:10.1177/08971900251384153

Kennedi Satterfield, Jessica L Elefritz, Kyle Quirk, Jennica Johns, Sarah Ehrman, Eric M McLaughlin, Brookeanne Magrum

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Abstract

Background: Buprenorphine is an opioid that has recently gained interest for acute pain management in post-operative patients. It has theoretical advantages due to its unique mechanism and favorable adverse effect profile. Currently, no studies have evaluated intravenous buprenorphine for acute pain management in a critically ill medical patient population.

Objective: The objective of this study was to compare the use of intravenous buprenorphine with or without a full agonist IV opioid vs a full agonist IV opioid alone for acute pain in non-ventilated, non-surgical critically ill patients.

Methods: A retrospective cohort study was completed of patients who received IV buprenorphine or full-agonist opioids while admitted to the medical intensive care unit at an academic medical center and community hospital.

Results: The median DVPRS difference in the buprenorphine group compared to the control group was 5 vs 6. The non-inferiority t-test showed buprenorphine was not significantly non-inferior with mean DVPRS score at day 3 for the buprenorphine group was 5.02 and the control group was 5.07 (P = 0.85). Respiratory depression within 7 days occurred less in the buprenorphine group (20.6% vs 42.9%, P = 0.004). Oversedation occurred less in the buprenorphine group (27% vs 46.8%, P = 0.01. The ICU LOS was longer in the buprenorphine group (8 vs 5 days, P = 0.01). The median daily OME on day 1 was less in the buprenorphine group (29 vs 42.5, P = 0.03).

Conclusion: Intravenous buprenorphine may be a comparable alternative to full agonist intravenous opioids for pain control in the medical intensive care unit.

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丁丙诺啡静脉注射治疗重症病人急性疼痛的疗效观察

背景：丁丙诺啡是一种阿片类药物，最近引起了术后患者急性疼痛管理的兴趣。其独特的作用机理和良好的不良反应分布具有理论优势。目前，没有研究评估静脉注射丁丙诺啡对危重病人急性疼痛管理的作用。目的：本研究的目的是比较静脉注射丁丙诺啡联合或不联合完全激动剂IV阿片类药物与单独使用完全激动剂IV阿片类药物治疗非通气、非手术危重患者急性疼痛的效果。方法：回顾性队列研究完成了在学术医疗中心和社区医院重症监护室接受静脉注射丁丙诺啡或充分激动剂阿片类药物的患者。结果：丁丙诺啡组与对照组相比，中位DVPRS差值为5比6。非劣效性t检验显示丁丙诺啡无明显劣效性，丁丙诺啡组第3天DVPRS平均评分为5.02，对照组为5.07 （P = 0.85）。丁丙诺啡组7天内呼吸抑制发生率较低（20.6% vs 42.9%, P = 0.004）。丁丙诺啡组过度镇静发生率较低（27% vs 46.8%, P = 0.01）。丁丙诺啡组ICU LOS较长（8天vs 5天，P = 0.01）。丁丙诺啡组第1天的每日OME中位数较低（29 vs 42.5, P = 0.03）。结论：在重症监护病房，静脉注射丁丙诺啡可能是完全激动剂静脉注射阿片类药物控制疼痛的可比替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pharmacy practice PHARMACOLOGY & PHARMACY-

CiteScore

3.20

自引率

7.70%

发文量

184

期刊介绍： The Journal of Pharmacy Practice offers the practicing pharmacist topical, important, and useful information to support pharmacy practice and pharmaceutical care and expand the pharmacist"s professional horizons. The journal is presented in a single-topic, scholarly review format. Guest editors are selected for expertise in the subject area, who then recruit contributors from that practice or topic area.