For postoperative pain relief in people undergoing mastectomy, the analgesic effectiveness of 200 μg sublingual Buprenorphine appears to be similar to 100 mg intravenous Tramadol.

A randomized controlled trial compared the analgesic effectiveness of Buprenorphine with Tramadol in people undergoing mastectomy.

Overall, 60 patients with breast cancer were randomized into Buprenorphine group (n = 30) and  Tramadol group (n = 30). Subjects in the Buprenorphine group were given 200 μg of Buprenorphine sublingually three times per day, while those in the Tramadol group received 100 mg of Tramadol intravenously three times every day.

Sublingual Buprenorphine's analgesic effectiveness was similar to that of intravenous Tramadol. Visual Analogue Scale (VAS) scores exhibited no significant difference between the two groups at various time points (0, 1, 3, 6, 12, 18 and 24 hours) at rest and movement with the exception of 0 and 3 hours during movement when the score was reduced in the Tramadol group when compared to the Buprenorphine group. Rescue analgesics (intravenous Morphine 3 mg) were administered to four patients in the Buprenorphine group.

For acute postsurgical pain management following breast surgery, sublingual Buprenorphine has comparable analgesic efficacy as intravenous Tramadol and may be considered as a part of multimodal analgesia.