Neurológia pre prax 1/2024

Buprenorphine as an innovation in the treatment of chronic pain

The article discusses the possible causes of chronic pain with strong opioids , which can be accompanied by a number of complications if not managed professionally. Treatment of severe chronic pain cannot be imagined without strong opioids, but it is necessary to follow some simple recommendations for proper indication and monitoring of the whole course of treatment. In recent years, a new concept of classifying opioids based on their receptor mechanism of action has been promoted, and this concept may guide more gentle treatment with strong opioids, especially for non-cancer pain. The treatment of chronic pain with non-opioid analgesics is also risky in terms of adverse effects and drug interactions if not managed professionally. Buprenorphine is a partial μ-receptor agonist and was previously available in transdermal patches for the treatment of moderate to severe chronic pain of both tumor and non-tumor origin, and currently buprenorphine patches containing 5, 10, 15, 20, 30 and 40 μg/h are coming to market in new dosages. Health insurance reimbursement is currently for the 5, 20, 30 and 40 μg/h strengths. They are indicated for the treatment of moderate non-cancer pain in adult patients in cases where opioid administration is required to achieve sufficient analgesia. The therapy has the advantage of easy patch manipulation with an extended replacement interval of 7 days and easy titration of the buprenorphine dose, the treatment is sufficiently analgesic effective and well tolerated by patients.

Keywords: chronic pain, opioid and nonopioid analgesics, atypical opiod analgesics, WHO ladder, buprenorphine