Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review

Abstract. The availability of knowledge about the effects of buprenorphine on pain perception in healthy adults could help investigators select experimental tests with evidence of responsiveness to buprenorphine in nondiseased states. The purpose of this meta-narrative systematic review is to summar...

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Main Authors: W. Michael Hooten, Danielle Zheng, Nicholas C. Canzanello, Rajat N. Moman, Larry Prokop, Nathan D. Eberhart, Barlas Benkli, Salman Hirani
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001294
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author W. Michael Hooten
Danielle Zheng
Nicholas C. Canzanello
Rajat N. Moman
Larry Prokop
Nathan D. Eberhart
Barlas Benkli
Salman Hirani
author_facet W. Michael Hooten
Danielle Zheng
Nicholas C. Canzanello
Rajat N. Moman
Larry Prokop
Nathan D. Eberhart
Barlas Benkli
Salman Hirani
author_sort W. Michael Hooten
collection DOAJ
description Abstract. The availability of knowledge about the effects of buprenorphine on pain perception in healthy adults could help investigators select experimental tests with evidence of responsiveness to buprenorphine in nondiseased states. The purpose of this meta-narrative systematic review is to summarize the effects of buprenorphine on pain perception in healthy adults. Comprehensive database searches were conducted from inception dates through July 16, 2024. Inclusion criteria included all study designs involving healthy adults receiving buprenorphine and tests of pain perception. Risk of bias was assessed using a tool developed for randomized controlled trials (RCTs). A meta-narrative approach was used due to high levels of clinical heterogeneity. A total of 10 RCTs were included, and healthy adults comprised the comparator groups in all trials. Three RCTs had a low risk of bias, 6 had some concerns, and 1 had a high risk of bias. Six RCTs used intravenous buprenorphine, 3 used transdermal, and 1 study used intravenous and sublingual buprenorphine. The effects of buprenorphine on pain perception are influenced by the route of administration, dose, and pain stimulus modality. Considerable differences exist in the effects of intravenous and transdermal buprenorphine, but only 1 study used sublingual buprenorphine, which limited comparison with the other drug formulations. Based on these findings, recommendations for clinical trials are proposed. These recommendations should be cautiously interpreted due to the clinical heterogeneity, but they provide a framework for advancing the use of experimental pain tests in trials of buprenorphine involving comparator groups of healthy adults.
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spelling doaj-art-a1801d586add437c8d5d5e87052fa8382025-08-20T02:29:12ZengWolters KluwerPAIN Reports2471-25312025-06-01103e129410.1097/PR9.0000000000001294PR90000000000001294Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic reviewW. Michael Hooten0Danielle Zheng1Nicholas C. Canzanello2Rajat N. Moman3Larry Prokop4Nathan D. Eberhart5Barlas Benkli6Salman Hirani7a Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USAc Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USAa Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USAe Pain and Spine Centers of Florida, Lady Lake, FL, USAf Mayo Clinic Libraries, Rochester, MN, USAb Anesthesiology Systematic Review Group, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USAg Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USAh Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USAAbstract. The availability of knowledge about the effects of buprenorphine on pain perception in healthy adults could help investigators select experimental tests with evidence of responsiveness to buprenorphine in nondiseased states. The purpose of this meta-narrative systematic review is to summarize the effects of buprenorphine on pain perception in healthy adults. Comprehensive database searches were conducted from inception dates through July 16, 2024. Inclusion criteria included all study designs involving healthy adults receiving buprenorphine and tests of pain perception. Risk of bias was assessed using a tool developed for randomized controlled trials (RCTs). A meta-narrative approach was used due to high levels of clinical heterogeneity. A total of 10 RCTs were included, and healthy adults comprised the comparator groups in all trials. Three RCTs had a low risk of bias, 6 had some concerns, and 1 had a high risk of bias. Six RCTs used intravenous buprenorphine, 3 used transdermal, and 1 study used intravenous and sublingual buprenorphine. The effects of buprenorphine on pain perception are influenced by the route of administration, dose, and pain stimulus modality. Considerable differences exist in the effects of intravenous and transdermal buprenorphine, but only 1 study used sublingual buprenorphine, which limited comparison with the other drug formulations. Based on these findings, recommendations for clinical trials are proposed. These recommendations should be cautiously interpreted due to the clinical heterogeneity, but they provide a framework for advancing the use of experimental pain tests in trials of buprenorphine involving comparator groups of healthy adults.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001294
spellingShingle W. Michael Hooten
Danielle Zheng
Nicholas C. Canzanello
Rajat N. Moman
Larry Prokop
Nathan D. Eberhart
Barlas Benkli
Salman Hirani
Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
PAIN Reports
title Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
title_full Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
title_fullStr Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
title_full_unstemmed Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
title_short Effects of buprenorphine on pain perception in healthy adults: a meta-narrative systematic review
title_sort effects of buprenorphine on pain perception in healthy adults a meta narrative systematic review
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001294
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