{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:09:16Z","timestamp":1790014156869,"version":"4.0.1"},"reference-count":14,"publisher":"Weston Medical Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Introduction: Patients undergoing spinal fusion surgery often experience moderate to severe pain during the first three post-operative days. Few data are currently available regarding the use of specific opioid analgesics for the spine surgery population, which routinely experiences significant acute pain. This study aims to examine the perioperative use of sublingual sufentanil tablet (SST) as part of the analgesic regimen for spine surgery.Methods: This study was a prospective cohort (n = 30) with a two-arm (n = 80 each) historical control cohort. Both the prospective arm and the two retrospective control groups received a standard general anesthetic. The prospective arm received intraoperative sufentanil infusion and SST right after extubation and SST q1h in the post-anesthesia care unit (PACU) for Numerical Rating Scale (NRS) &gt; 3, with intravenous hydromorphone used for breakthrough pain. The control groups received intraoperative sufentanil infusion alone or intraoperative remifentanil infusion alone, both with subsequent intravenous hydromorphone used for breakthrough pain (similar to the prospective SST arm). Multivariable linear regression models with inverse probability of treatment weighting were used to measure the effectiveness of SST in reducing the primary outcome of post-operative pain intensity scores in the PACU.Results: A total of 190 patients were analyzed. The study group that received SST experienced lower average pain intensity scores in the PACU compared with the two historical control groups, with NRS scores of 3.22 in the SST group, 5.66 in the remifentanil group, and 5.05 in the sufentanil group. In the multivariable regression models, the SST group had an average PACU pain score that was 1.86 points lower (95 percent confidence interval [CI]: [\u20132.61, \u20131.10], p &lt; 0.001) than the remifentanil group, and that was 1.10 points lower (95 percent CI: [\u20131.87, \u20130.34], p = 0.005) than the sufentanil group.Conclusion: SST appears to be a potentially beneficial adjunctive analgesic therapy in spine surgery patients who experience moderate to severe post-operative pain, resulting in improved pain intensity scores in the post-operative recovery period. Further analysis should examine the impact on longer-term post-operative opioid consumption and post-discharge pain-related outcomes.<\/jats:p>","DOI":"10.5055\/jom.0981","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:27:21Z","timestamp":1790011641000},"page":"375-384","source":"Crossref","is-referenced-by-count":0,"title":["The effect of sublingual sufentanil on post-operative pain control in spine surgery"],"prefix":"10.5055","volume":"22","author":[{"given":"Linda S.","family":"Aglio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mendez-Pino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah A.","family":"Baez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Justice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara G.","family":"Fields","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina S\u00e1","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Oran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Abbaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0516-5977","authenticated-orcid":false,"given":"Richard D.","family":"Urman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3008","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"105587","doi-asserted-by":"crossref","unstructured":"Murphy GS, Szokol JW, Avram MJ, et al.: Clinical effectiveness and safety of intraoperative methadone in patients undergoing posterior spinal fusion surgery: A randomized, double-blinded, controlled trial. Anesthesiology. 2017; 126(5): 822-833. DOI: 10.1097\/ALN.0000000000001609.","DOI":"10.1097\/ALN.0000000000001609"},{"key":"105588","doi-asserted-by":"crossref","unstructured":"Meijer F, Cornelissen P, Sie C, et al.: Sublingual sufentanil for postoperative pain relief: First clinical experiences. J Pain Res. 2018; 11: 987-992. DOI: 10.2147\/JPR.S160091.","DOI":"10.2147\/JPR.S160091"},{"key":"105589","doi-asserted-by":"crossref","unstructured":"Fisher DM, Chang P, Wada DR, et al.: Pharmacokinetic properties of a sufentanil sublingual tablet intended to treat acute pain. Anesthesiology. 2018; 128(5): 943-952. DOI: 10.1097\/ALN.0000000000002145.","DOI":"10.1097\/ALN.0000000000002145"},{"key":"105590","doi-asserted-by":"crossref","unstructured":"Miner JR, Melson TI, Leiman D, et al.: Pooled phase III safety analysis of sufentanil sublingual tablets for short-term treatment of moderate-to-severe acute pain. Pain Manag. 2019; 9(3): 259-271. DOI: 10.2217\/pmt-2018-0090.","DOI":"10.2217\/pmt-2018-0090"},{"key":"105591","doi-asserted-by":"crossref","unstructured":"Reardon CE, Kane-Gill SL, Smithburger PL, et al.: Sufentanil sublingual tablet: A new option for acute pain management. Ann Pharmacother. 2019; 53(12): 1220-1226. DOI: 10.1177\/1060028019863144.","DOI":"10.1177\/1060028019863144"},{"key":"105592","doi-asserted-by":"crossref","unstructured":"Tvetenstrand CD, Wolff ME: Reduced opioid use and reduced time in the postanesthesia care unit following preoperative administration of sublingual sufentanil in an ambulatory surgery setting. Clin Anesth Pain Manag. 2020; 4(2): 123-128. DOI: 10.36959\/377\/341.","DOI":"10.36959\/377\/341"},{"key":"105593","unstructured":"Cassavaugh KM, Hogan SM, Senska JC, et al.: A medication use evaluation of sufentanil sublingual tablet 30 mcg for the perioperative management of surgical pain. Univ Surg. 2020; 8(5). DOI: 10.36648\/2254-6758.8.5.136."},{"key":"105594","doi-asserted-by":"crossref","unstructured":"Wiesner L, Tvetenstrand CD: Reduced opioid use and hospital stay in patients undergoing total knee or total hip arthroplasty when treated with sublingual sufentanil compared with standard of analgesic care. J Orthop Exp Innov. 2021; 2(2). https:\/\/doi:org\/10.60118\/001c.29105.","DOI":"10.60118\/001c.29105"},{"key":"105595","doi-asserted-by":"crossref","unstructured":"Seify H: Sufentanil sublingual tablet reduces postoperative opioid use following outpatient plastic surgery. Aesthet Surg J Open Forum. 2022; 4: Ojac040. DOI: 10.1093\/asjof\/ojac040.","DOI":"10.1093\/asjof\/ojac040"},{"key":"105596","doi-asserted-by":"crossref","unstructured":"Seify H: Awake plastic surgery procedures: The use of a sufentanil sublingual tablet to improve patient experience. Aesthet Surg J Open Forum. 2022; 4: Ojab056. DOI: 10.1093\/asjof\/ojab056.","DOI":"10.1093\/asjof\/ojab056"},{"key":"105597","doi-asserted-by":"crossref","unstructured":"Cizik AM, Lee MJ, Martin BI, et al.: Using the spine surgical invasiveness index to identify risk of surgical site infection. J Bone Joint Surg Am. 2012; 94(4): 335-342. DOI: 10.2106\/JBJS.J.01084.","DOI":"10.2106\/JBJS.J.01084"},{"key":"105598","doi-asserted-by":"crossref","unstructured":"Buonaccorsi JP, Laake P, Veierod MB: On the power of the Cochran-Armitage test for trend in the presence of misclassification. Stat Methods Med Res. 2014; 23(3): 218-243. DOI: 10.1177\/0962280211406424.","DOI":"10.1177\/0962280211406424"},{"key":"105599","doi-asserted-by":"crossref","unstructured":"Farrar JT, Young JP, Jr, LaMoreaux L, et al.: Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001; 94(2): 149-158. 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