Buprenorphine for Analgesia in Older Adults With Acute Fractures in the Emergency Department: a Randomized Controlled Study
The Cooper Health System
Summary
The goal of this clinical trial is to learn if buprenorphine can treat pain in older adults who have broken bones. The main questions it aims to answer are: Is buprenorphine as effective as opioids to treat pain? Are there less side effects with buprenorphine? Researchers will compare buprenorphine and hydromorphone to see if there are differences in pain control and side effects. Participants will be given one of the two study drugs after breaking a bone and asked about their pain scores and side effects for the next 48 hours.
Description
Older adults are prone to fractures but are less likely to receive adequate analgesia in the Emergency Department (ED)due to concerns for side effects including respiratory depression, sedation, delirium, and constipation, however untreated pain can induce delirium, decrease satisfaction, and impede functional recovery. Buprenorphine is a partial opioid agonist with analgesic properties, does not require dosing changes in renal or hepatic insufficiency, and may have a ceiling on respiratory depression. Prior studies have demonstrated similar or improved efficacy compared to full agonist opioid…
Eligibility
- Age range
- 65+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age 65 years or older * Emergency Department patient * Diagnosis of suspected or confirmed acute fracture * Numerical Rating Scale 4 or greater at time of presentation * Must be able to give informed consent or have a surrogate decisionmaker to provide informed consent * Subjects who may require a surgical procedure are eligible for enrollment, as given the low dose of buprenorphine, this is not anticipated to affect future anesthesia. If additional pain control is needed for surgical procedure, full agonist opioid can be used without contraindication. Exclusion Criteri…
Interventions
- DrugBuprenorphine 0.15 MG
given every 15 minutes as needed for numerical pain score 4 or greater for a maximum of three doses
- DrugHydromorphone 0.25 mg IV
given every 15 minutes as needed for numerical pain score 4 or greater for a maximum of three doses
Location
- Cooper University HospitalCamden, New Jersey