Comparing Buprenorphine and Hydromorphone for Pain Relief in Older Adults with Broken Bones in the Emergency Department

What this Trial Is About

This trial investigates the use of buprenorphine for pain relief in older adults aged 65 and above who have suffered acute fractures. The study aims to determine whether buprenorphine is as effective as hydromorphone, a full opioid agonist, in managing pain while possibly causing fewer side effects such as respiratory depression, sedation, delirium, and constipation. Older adults are often underrepresented in pain management studies despite their unique needs due to comorbidities and polypharmacy. Participants will receive either buprenorphine 0.15 mg IV or hydromorphone 0.25 mg IV every 15 minutes as needed for pain scores of 4 or greater, with a maximum of three doses. This randomized, single-blind study compares these two treatments over a 48-hour period to assess pain control and adverse side effects. The research is conducted in an emergency department setting where patients present with suspected or confirmed fractures. During the study, participants will be monitored for pain levels and side effects for up to 48 hours, with assessments including pain scores at 4 hours and evaluation of adverse events such as need for rescue medications or naloxone administration. Researchers will also track total opioid use and mortality up to 30 days. Participants may be asked about their pain and side effect experiences during this time to help determine the safety and effectiveness of buprenorphine compared to hydromorphone.

Buprenorphine for Analgesia in Older Adults With Acute Fractures in the Emergency Department