title: Sublingual buprenorphine in acute pain management: a double-blind randomized clinical trial.
abstract: OBJECTIVE
  We compare the efficacy and safety of sublingual buprenorphine versus intravenous morphine sulfate in emergency department adults with acute bone fracture.
  
  
  METHODS
  Enrolled patients received buprenorphine 0.4 mg sublingually or morphine 5 mg intravenously in this double-blind, double-dummy, randomized controlled trial. Patients graded their pain with a standard 11-point numeric rating scale before medication administration and 30 and 60 minutes after, and we recorded adverse reactions.
  
  
  RESULTS
  We analyzed 44 and 45 patients in the buprenorphine and morphine groups, respectively. Mean pain scores were similar at 30 minutes (5.0 versus 5.0; difference 0; 95% confidence interval -0.6 to 0.8) and at 60 minutes (2.2 versus 2.2; difference 0; 95% confidence interval -0.3 to 0.3). Adverse effects observed within 30 minutes were nausea (14% versus 12%), dizziness (14% versus 22%), and hypotension (4% versus 18%).
  
  
  CONCLUSIONS
  For adults with acute fractures, buprenorphine 0.4 mg sublingually is as effective and safe as morphine 5 mg intravenously.
authors: Emergency Department, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. mjalili@tums.ac.ir.
authors: Mohammad
authors: M
authors: Jalili
authors: Marzieh
authors: M
authors: Fathi
authors: Maziar
authors: M
authors: Moradi-Lakeh
authors: Shahriar
authors: S
authors: Zehtabchi
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002047:Buprenorphine / Q000008:administration & dosage; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D009020:Morphine