Efficacy and safety of transdermal buprenorphine for acute postoperative pain: A systematic review and meta-analysis
Abstract
Transdermal buprenorphine (TBUP) may have some advantages for the management of acute postoperative pain. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of TBUP compared to other analgesics or placebo for acute postoperative pain. A systematic search was conducted using Embase, MEDLINE and CENTRAL until the 26th of December 2022. The search included randomised controlled trials comparing TBUP versus other analgesics or placebo for acute postoperative pain. A certainty assessment was conducted using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. The protocol for this review was registered on PROSPERO (CRD42022318601). In total, 15 studies involving 1,205 participants were included that compared TBUP versus fentanyl (n=2), celecoxib (n=3), placebo (n=2), tramadol (n=5), diclofenac (n=3), parecoxib (n=1) and flurbiprofen (n=1). Meta-analyses were conducted for three comparators that involved 2 studies each. There was no significant difference in pain between TBUP 10mcg/h vs fentanyl 25 mcg/h (SMD -0.03, 95% CI -0.86 to 0.81, p=0.95, I2=85%). TBUP 10 mcg/h was associated with less pain compared to celecoxib 200 mg twice daily (SMD -0.32, 95% CI -0.58 to -0.05, p=0.02, I2=0%) and placebo (SMD -2.29, 95% CI -4.32 to -0.27, p=0.03, I2=94%). The GRADE assessment showed a very low certainty of evidence for all comparisons. There is insufficient evidence that TBUP improves pain control compared to…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,205 participants or records.
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