Sublingual Buprenorphine and Intravenous Morphine Provide Similar Analgesia

Buprenorphine is familiar to most physicians as an ingredient of Suboxone (along with naloxone), which is used to treat opioid addiction. During chronic therapy with buprenorphine or buprenorphine-naloxone, respiratory depression is unlikely, but acute monotherapy with buprenorphine carries similar risks of respiratory depression, as with other opioids. Few studies have evaluated buprenorphine as an analgesic in the emergency department (ED) setting.

In an academic ED in Iran, investigators randomized 89 patients (age ≥16) with extremity fractures to receive 0.4 mg buprenorphine sublingually or 5 mg morphine intravenously, with double-dummy blinding. Mean pain scores on an 11-point verbal rating scale decreased from 8.0 in the buprenorphine …