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Perioperative Management of Extended-release Buprenorphine
Thomas R Hickey1, Jonathan T Henry, Ellen L Edens
1From the VA Connecticut Healthcare System, Yale University School of Medicine (TRH); Addictions Treatment Program, Jesse Brown VAMC, Chicago, IL (JTH); VA Connecticut Healthcare System, Department of Psychiatry, Yale School of Medicine (ELE); Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (AJG); Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, University of Utah School of Medicine, Salt Lake City, UT (AJG); MGH/Harvard Center for Addiction Medicine, Pain Management Center at MGH, Boston, MA (GA); and Harvard Medical School, Massachusetts General Hospital, Boston, MA (GA).
Abstract:
Perioperative management of buprenorphine is increasingly characterized by continuation of buprenorphine throughout the perioperative period while coadministering full agonist opioids for analgesia. Although this "simultaneous strategy" is commonly used for the shorter-acting sublingual buprenorphine formulations, there is little to guide management of the extended-release formulations of buprenorphine. Here we report the perioperative experience of an individual maintained on extended-release buprenorphine who successfully underwent major surgeries utilizing a strategy of performing the surgeries at the time of the next scheduled dose.
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