ESRA Academy. Katz P. Sep 8, 2016; 138248; 0066 Topic: Patient Controlled Analgesia
Pablo Katz
Pablo Katz

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Background and Aims:

An exploratory analysis was undertaken to compare effectiveness of a sufentanil sublingual tablet system (SSTS) (Zalviso®) versus a fentanyl iontophoretic transdermal system (ITS) (Ionsys®), both non-invasive patient controlled analgesia systems (PCA) indicated for acute moderate to severe post-operative pain.


Literature searches in main databases were conducted from 2004 to 2015. To be included in the analysis, trials had to meet pre-defined eligibility criteria. Only active comparator studies were accepted. The analysis was performed by means of an indirect treatment comparison (ITC).


Five studies were identified that could be included in this analysis. In all studies the active comparator was intra-venous PCA morphine. For Patient Global Assessment of the method of pain control (PGA) scores of “good” or “excellent” the results were significantly in favour of SSTS at 24 hours (RR: 1.17; 95% CI: 1.02 to 1.34) and numerically in favour of SSTS at the 48‑hour and 72 hour time points. Furthermore regarding the Healthcare Professional Global Assessment (HPGA) results were significantly in favour of SSTS at 24 hours (RR: 1.21; 95% CI: 1.07 to 1.38) and 48 hours (RR: 1.2; 95% CI: 1.04 to 1.38) and numerically in favour of SSTS at the 72 hour time point (RR: 1.13; 95% CI: 0.98 to 1.29). (Figure 1)


For both outcomes, PGA and HPGA, (PGA-24 was the primary endpoint in ITS studies and PGA-48 was the primary endpoint in the SSTS study) SSTS has shown statistical or numerical advantages.

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