Evaluation of the Efficacy of Sublingual Sufentanil (Prescribed as Rescue Analgesia for Acute Postoperative Pain) on the Quality of Health Recovery After Surgery: a Randomized, Controlled, Multicenter, Open-label Trial Against an Active Comparator (SUBLIME)

Evaluation of the Efficacy of Sublingual Sufentanil (Prescribed as Rescue Analgesia for Acute Postoperative Pain) on the Quality of Health Recovery After Surgery: a Randomized, Controlled, Multicenter, Open-label Trial Against an Active Comparator (SUBLIME)

The number of surgical procedures performed annually exceeds 300 million worldwide and continues to grow. The management of the most common perioperative symptoms (pain, nausea/vomiting, constipation) represents a major public health challenge.

In the context of postoperative pain management, a multimodal analgesia strategy is recommended in order to minimize opioid consumption. The opioid currently most commonly used is oral morphine sulfate. New therapeutic options are emerging, including sublingual sufentanil (Dzuveo®, 30 µg), which combines opioid-like effects with a faster onset of action due to its lipophilicity.

The hypothesis of this study is that, because of its unique pharmacokinetic and pharmacodynamic profile, this new formulation is more effective than oral morphine sulfate in the treatment of postoperative pain and in the recovery of health status.

Inclusion Criteria:

Aged 18 years or older (with no upper age limit) Undergoing surgery in a surgical department of the participating centers for a procedure whose usual postoperative management includes the prescription of an oral rescue opioid analgesic Able to provide informed consent Affiliated with a health insurance/social security system or beneficiary of such a system

Exclusion Criteria:

Known hypersensitivity to the components of Sublingual sufentanil 30 µg Known hypersensitivity to the components of Morphine sulfate Compromised respiratory function, such as decompensated respiratory failure or respiratory depression Severe hepatic insufficiency (i.e., with encephalopathy) Severe renal insufficiency (GFR < 30) Acute head trauma with intracranial hypertension Uncontrolled epilepsy Ileus Patients receiving daily preoperative treatment with opioids such as morphine, sufentanil, fentanyl, oxycodone, buprenorphine, nalbuphine, methadone, naltrexone, nalmefene, or sodium oxybate Pregnant or breastfeeding women Incapacitated individuals (subject to legal protection measures: judicial protection, curatorship, guardianship, future protection mandate, or family authorization) Inability to administer the mQoR-15f questionnaire (cognitive impairment, language barrier) or inability to provide informed information to the subject (emergency situations, subject's comprehension difficulties, etc.)