Sublingual Sufentanil Attenuates Perceived Pain, But Not Blood Pressure Responses, During A Cold Pressor Test

Authors

Caitlin P. Jarrard, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TXFollow
Zachary J. McKenna, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TXFollow
Whitley C. Atkins, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TXFollow
Josh Foster, Kings College LondonFollow
Joseph C. Watso, Florida State UniversityFollow
Craig G. Crandall, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TXFollow

Abstract

Sublingual sufentanil was developed to reduce pain following a traumatic injury in the field (e.g., battlefield). However, it is unknown whether an analgesic dose of sufentanil affects cardiovascular responses to a painful stimulus in humans. PURPOSE: We tested the hypothesis that sublingual sufentanil blunts pain perception and the accompanying cardiovascular responses during a cold pressor test (CPT). METHODS: Twenty-nine adults, 15 males and 14 females (age: 29 ± 5 years, body mass: 74 ± 8 kg, body mass index: 25 ± 2 kg/m²) participated in this double-blind, randomized, crossover, placebo-controlled trial. Following sublingual administration of sufentanil (30 µg) or placebo, participants underwent a two-minute resting baseline period and then a two-minute CPT (hand in 0.07 ± 0.10°C ice-water), while heart rate (electrocardiography) and beat-to-beat blood pressure (photoplethysmography - Finometer) were measured continuously. Pain perception (100 mm visual analog scale) was compared between trials via a two-tailed Wilcoxon Signed-Rank test. Heart rate and blood pressure responses were compared using a mixed effects model (trial x time). Changes (Δ) in heart rate and blood pressure from baseline to the last 30 seconds of the CPT were compared using a two-tailed Wilcoxon Signed-Rank test and a two-tailed paired t-test, respectively. RESULTS: Sufentanil attenuated perceived pain (sufentanil: 35 [27 – 53] vs. placebo: 68 [38 – 82] mm, p < 0.001) during the CPT. The magnitude of the increase in heart rate to the CPT was influenced by the drug (trial: p = 0.061, time: p < 0.001, interaction: p < 0.001), with the Δ heart rate being greater for the placebo trial (p = 0.002). Both absolute mean blood pressure responses (trial: p = 0.071, time: p < 0.001, interaction: p = 0.245) and Δ mean blood pressure to the CPT (sufentanil: 15 ± 9 vs. placebo: 16 ± 8, p = 0.334) were not different between trials. CONCLUSION: These data suggest that 30 µg of sublingual sufentanil attenuates perceived pain, but not the accompanying blood pressure responses, during the CPT.

Recommended Citation

Jarrard, Caitlin P.; McKenna, Zachary J.; Atkins, Whitley C.; Foster, Josh; Watso, Joseph C.; and Crandall, Craig G. (2024) "Sublingual Sufentanil Attenuates Perceived Pain, But Not Blood Pressure Responses, During A Cold Pressor Test," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 16, Article 67.
Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss16/67