Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis
Introduction. In lab-based studies, buprenorphine appears to have a ceiling effect on respiratory depression but not on analgesia. There is increasing evidence in adult patients that buprenorphine has no ceiling effect on analgesia or side effects. The aim of this study was to investigate the effica...
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| Format: | Article |
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Wiley
2018-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/3792043 |
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| author | Nathan Murray Utsav Malla Ruan Vlok Alice Scott Olivia Chua Thomas Melhuish Leigh White |
| author_facet | Nathan Murray Utsav Malla Ruan Vlok Alice Scott Olivia Chua Thomas Melhuish Leigh White |
| author_sort | Nathan Murray |
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| description | Introduction. In lab-based studies, buprenorphine appears to have a ceiling effect on respiratory depression but not on analgesia. There is increasing evidence in adult patients that buprenorphine has no ceiling effect on analgesia or side effects. The aim of this study was to investigate the efficacy and adverse effects of buprenorphine versus morphine in paediatric acute pain. Methods. A systematic review of five databases was performed until May 2018. Only randomised controlled trials were eligible for inclusion. The outcomes of interest included pain, respiratory depression, nausea, sedation, dizziness, and pruritus. Results. Four randomised controlled trials (n=195) were included. The only outcome measuring analgesic efficacy was time to breakthrough analgesia. Buprenorphine had a significant increase in time to breakthrough analgesia by 114.98 minutes compared to morphine (95% CI = 42.94 to 187.01; I2 = 0; p=0.002). There was no significant difference in the rates of adverse effects. Conclusions. Buprenorphine provided a longer duration of analgesia than morphine. This in combination with its unique sublingual preparation could prove particularly advantageous in the paediatric population. The studies included are likely underpowered to detect differences in the incidence of adverse effects; therefore, the same precautions should be taken as with any other opioid. |
| format | Article |
| id | doaj-art-e656d506826d4f448159051eedf68f0d |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Critical Care Research and Practice |
| spelling | doaj-art-e656d506826d4f448159051eedf68f0d2025-08-20T03:26:04ZengWileyCritical Care Research and Practice2090-13052090-13132018-01-01201810.1155/2018/37920433792043Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-AnalysisNathan Murray0Utsav Malla1Ruan Vlok2Alice Scott3Olivia Chua4Thomas Melhuish5Leigh White6Department of Anaesthesia and Pain Medicine, Sunshine Coast University Hospital, Birtinya, QLD, AustraliaDepartment of Anaesthesia and Pain Medicine, Sunshine Coast University Hospital, Birtinya, QLD, AustraliaWagga Wagga Base Hospital, Wagga Wagga, NSW, AustraliaWagga Wagga Base Hospital, Wagga Wagga, NSW, AustraliaWagga Wagga Base Hospital, Wagga Wagga, NSW, AustraliaSchool of Medicine, University of New South Wales, Sydney, NSW, AustraliaDepartment of Anaesthesia and Pain Medicine, Sunshine Coast University Hospital, Birtinya, QLD, AustraliaIntroduction. In lab-based studies, buprenorphine appears to have a ceiling effect on respiratory depression but not on analgesia. There is increasing evidence in adult patients that buprenorphine has no ceiling effect on analgesia or side effects. The aim of this study was to investigate the efficacy and adverse effects of buprenorphine versus morphine in paediatric acute pain. Methods. A systematic review of five databases was performed until May 2018. Only randomised controlled trials were eligible for inclusion. The outcomes of interest included pain, respiratory depression, nausea, sedation, dizziness, and pruritus. Results. Four randomised controlled trials (n=195) were included. The only outcome measuring analgesic efficacy was time to breakthrough analgesia. Buprenorphine had a significant increase in time to breakthrough analgesia by 114.98 minutes compared to morphine (95% CI = 42.94 to 187.01; I2 = 0; p=0.002). There was no significant difference in the rates of adverse effects. Conclusions. Buprenorphine provided a longer duration of analgesia than morphine. This in combination with its unique sublingual preparation could prove particularly advantageous in the paediatric population. The studies included are likely underpowered to detect differences in the incidence of adverse effects; therefore, the same precautions should be taken as with any other opioid.http://dx.doi.org/10.1155/2018/3792043 |
| spellingShingle | Nathan Murray Utsav Malla Ruan Vlok Alice Scott Olivia Chua Thomas Melhuish Leigh White Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis Critical Care Research and Practice |
| title | Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis |
| title_full | Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis |
| title_fullStr | Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis |
| title_short | Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis |
| title_sort | buprenorphine versus morphine in paediatric acute pain a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2018/3792043 |
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