The impact of Sublingual Sufentanil on Postoperative Pain Control in Patients Undergoing Spine Surgery

Background: Spine surgery patients experience significant pain post-surgery. The FDA approved Sublingual Sufentanil Tablet (SST), Dsuvia®, to reduce pain, time in the post-anesthesia care unit (PACU), and long-term opioid consumption. This study assessed the impact of perioperative SST on PACU pain scores as additional postoperative analgesic regimen for spine surgery.

Methods: IRB-approved, prospective cohort, two-arm historical control study included patients that received standard general anesthetic with the exception that the prospective arm received SST right after extubation and SST q1h in the PACU for NRS>3 (neither control arms received SST). Patients were >18 years old undergoing spine surgery (up to 3 levels), with ASA PS classification 1-3, and a planned inpatient stay. Multivariable linear regression with inverse probability of treatment weights was used to evaluate the association between SST and PACU pain scores.

Results: N=190 patients were analyzed (Table 1). Linear regression showed that patients receiving SST had a 2.20 point lower PACU pain score (p<0.001) than patients receiving Remifentanil and a 1.75 point lower pain score (p<0.001) than patients receiving Sufentanil (Table 2).

Conclusion: SST demonstrates an effective alternative analgesic therapy in spine surgery patients who experience moderate to severe postoperative pain, resulting in reduced pain scores postoperatively.