Author(s): ,
Buyck, K.*
UZ Leuven, Anesthesiology, Leuven, Belgium
Van de Velde, M.
UZ Leuven, Anesthesiology, Leuven, Belgium
Dreelinck, R.
UZ Leuven, Anesthesiology, Leuven, Belgium
Hoogma, D.
UZ Leuven, Anesthesiology, Leuven, Belgium
ESRA Academy. Buyck K. Sep 13, 2017; 190967; 186 Topic: PAIN THERAPY (ACUTE - CHRONIC)
Dr. Katelijne Buyck
Dr. Katelijne Buyck

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Background and Aims:

A multimodal approach for postoperative analgesia, combining non-opioid analgesics, locoregional anesthesia and strong opioids, is used for total hip arthroplasty (THA) in our institution. Patient-controlled analgesia (PCA) is used to allow patients to self-titrate and relieve moderate-to-severe pain. The sufentanil sublingual tablet system (SSTS) is a new oral PCA drug delivery system, intended to overcome some of the drawbacks of intravenous PCA. We retrospectively compared the postoperative pain relief and adverse events of the SSTS to the standard analgesic treatment after THA.


After approval of the ethical committee a retrospective cohort-study was performed comparing data from patients undergoing THA receiving SSTS (n=40) to standard analgesic treatment with parenteral and enteral opioids (n=40). We evaluated total opioid consumption, numerical rating scale (NRS) for pain and adverse events during 48 hours postoperatively.


Baseline patient characteristics did not differ between the two groups. The median NRS-pain score 24 hours postoperative was statistically lower in the SSTS group compared to control (NRS 2 (median) vs NRS 3, p<0.004) (Figure 1). Total intravenous morphine equivalent consumption in the SSTS-group was significantly higher compared to control (p<0.0004), however groups were not different with respect to adverse events (Table 1).


This study suggests that SSTS is an effective PCA modality in patients after THA. As it is preprogrammed and noninvasive, it may overcome some of the complications of intravenous PCA. Further RCT’s are warranted to evaluate if SSTS is indeed an effective and safe alternative for the management of postoperative pain.

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