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舌下芬太尼治疗中重度疼痛的最新概述。

An up-to-date overview of sublingual sufentanil for the treatment of moderate to severe pain.

机构信息

Department of Anaesthesia and Operative Services, Kuopio University Hospital , Kuopio, Finland.

出版信息

Expert Opin Pharmacother. 2020 Aug;21(12):1407-1418. doi: 10.1080/14656566.2020.1766025. Epub 2020 Jun 3.

Abstract

INTRODUCTION

Sufentanil is a selective µ-opioid agonist, used intravenously and intrathecally for moderate to severe acute pain. Sublingual sufentanil nanotablets have been developed; 15 mcg tablet for a patient-controlled analgesia device and 30-mcg tablet for a single-dose device administered by a healthcare professional. Dosing interval is a minimum of 20 min for a 15 mcg tablet and a treatment duration of up to 72 hours. The single 30-mcg nanotablet dosing interval is 1 hour. Mean plasma elimination half-life is 13 hours and bioavailability 47-57% after the first sublingual sufentanil tablet.

AREAS COVERED

This review focuses on the effectiveness, safety, and feasibility of sublingual sufentanil 30-mcg single dose suspended by a healthcare professional for the management of moderate to severe acute pain. A few Phase 4 studies concerning the sublingual sufentanil tablet system containing 15-mcg nanotablets are also reviewed.

EXPERT OPINION

Sufentanil sublingual 30-mcg nanotablets provide effective pain relief in various acute moderate to severe pain states. The safety profile of sublingual sufentanil 30 mcg is typical to opioids nausea, vomiting, and sedation being the most common ones. Sublingual sufentanil 30-mcg nanotablet has the potential for efficient moderate to severe pain management in supervised healthcare facilities.

摘要

简介

舒芬太尼是一种选择性μ-阿片受体激动剂,用于治疗中重度急性疼痛,可静脉内和鞘内给药。已开发出舒芬太尼舌下纳米片剂;15 mcg 片剂用于患者自控镇痛设备,30 mcg 片剂用于由医疗保健专业人员单次给药的设备。15 mcg 片剂的给药间隔至少为 20 分钟,治疗持续时间最长可达 72 小时。单次使用 30 mcg 纳米片剂的给药间隔为 1 小时。首次舌下舒芬太尼片剂后,平均血浆消除半衰期为 13 小时,生物利用度为 47-57%。

涵盖领域

本文重点关注由医疗保健专业人员悬浮给予的 30 mcg 单剂量舌下舒芬太尼在治疗中重度急性疼痛方面的有效性、安全性和可行性。还回顾了几项关于包含 15 mcg 纳米片剂的舌下舒芬太尼片剂系统的 4 期研究。

专家意见

舒芬太尼舌下 30 mcg 纳米片剂可有效缓解各种急性中度至重度疼痛状态。舌下舒芬太尼 30 mcg 的安全性特征与阿片类药物相似,最常见的是恶心、呕吐和镇静。舌下舒芬太尼 30 mcg 纳米片剂有可能在监管良好的医疗保健设施中高效管理中度至重度疼痛。

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