Anesthesia Medical News about Administration, Cutaneous Buprenorphine Pain

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Transdermal buprenorphine – a critical appraisal of its role in pain management
Journal of Pain Research, 09/16/09

Hans G et al. – This review paper focuses almost entirely on the clinical experience concerning the transdermal administration of buprenorphine, although preclinical aspects are also addressed in order to provide a complete picture of the unique pharmacological properties of this analgesic drug. Mounting evidence indicates the appropriateness of BUP TDS in the treatment of diverse acute and chronic pain syndromes which have been less or not responsive to other opioids. Additionally, BUP TDS seems to hold great promise for other difficult–to–treat (pain) conditions, such as patients in the intensive care setting. However, its use is somewhat tempered by the occurrence of local skin reactions which have been shown to be often therapy resistant.

Exclusive Author Commentary
Guy Hans, 09/17/09

The transdermal administration of buprenorphine has some highly interesting clinical features. First of all, it shows excellent pain relief in many different types of pain (like nociceptive but also neuropathic pain which is sometimes more resistant to other general analgesics). It is also very useful for the (long-term) treatment of cancer pain. In addition, transdermal buprenorphine carries a lesser risk for the development of respiratory depression than other opioids, making it safer to use in patients suffering from severe pain. Its use is however somewhat limited by the occurrence of skin reactions which are sometimes difficult to treat. Finally, the unique pharmacological properties of buprenorphine, make this drug suitable for use in specific - difficult to treat - clinical settings, like patients on intensive care (who are often difficult to treat due to the prolonged administration of iv opioids) and post-trauma patients who need good quality of analgesia during the revalidation without sedation or other central side effects. Further large-scale studies on transdermal buprenorphine in these specific clinical settings should be considered.

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