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Perioperative Buprenorphine Management: A Multidisciplinary Approach.
Thomas Hickey1, Audrey Abelleira2, Gregory Acampora3
1VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Anesthesiology, Yale School of Medicine, 950 Campbell Avenue, West Haven, CT 06516, USA.
The Medical Clinics of North America
|November 26, 2021
Summary
Buprenorphine, a treatment for pain and opioid use disorder (OUD), can be safely managed perioperatively with a multimodal strategy. This approach allows continuous buprenorphine treatment alongside other pain relievers, simplifying care.
Area of Science:
- Anesthesiology
- Pharmacology
- Addiction Medicine
Background:
- Buprenorphine is a key treatment for opioid use disorder (OUD) and pain.
- Traditional perioperative care required buprenorphine cessation for full agonist opioid (FAO) use.
- This cessation posed challenges for OUD management and pain control.
Observation:
- Mounting evidence supports a shift in perioperative management strategies.
- Patients on long-term buprenorphine require tailored pain management during surgery.
- The need for continuous OUD treatment is critical.
Findings:
- A multimodal analgesic strategy is safe and effective for patients on buprenorphine.
- This strategy involves simultaneous buprenorphine and FAO administration.
- It includes nonopioid adjuncts (acetaminophen, NSAIDs) and regional anesthesia.
Implications:
- This approach simplifies perioperative pain management for buprenorphine patients.
- It ensures seamless continuity of OUD treatment post-discharge.
- It offers a more effective and patient-centered care model.
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