Related Experiment Video
Updated: Jun 23, 2025
04:13
Less-Invasive Technique for Non-stabilized Mandibular Fracture in Mouse Models
Published on: September 27, 2024
333
Optimizing Safe Opioid Prescribing: A Paradigm Shift in Buprenorphine Management for Orthopaedic Surgery
Patrick J Morrissey1, Matthew Quinn1, Brian Mikolasko2
1Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
The Journal of Arthroplasty
|June 24, 2024
Summary
Continue buprenorphine for patients undergoing surgery to manage pain effectively. This approach, combined with multimodal analgesia and potential transdermal buprenorphine, improves perioperative pain control.
Area of Science:
- Pain Management
- Pharmacology
- Orthopaedic Surgery
Background:
- The opioid epidemic and COVID-19 pandemic highlight the need for innovative pain management strategies.
- Buprenorphine, a long-acting opioid, offers a favorable safety profile and accessibility for pain relief.
- Orthopaedic surgeons face challenges managing patients on buprenorphine perioperatively.
Purpose of the Study:
- To update orthopaedic surgeons on buprenorphine's role in pain relief.
- To provide evidence-based guidelines for perioperative buprenorphine management.
- To explore transdermal buprenorphine for acute perioperative pain.
Main Methods:
- Review of current literature on buprenorphine in pain management.
- Development of evidence-based practice guidelines for perioperative buprenorphine use.
- Discussion of multimodal analgesia strategies alongside buprenorphine.
- Evaluation of transdermal buprenorphine for postoperative pain control.
Main Results:
- Patients on buprenorphine should continue their home dose throughout the perioperative period.
- Multimodal analgesia, including regional anesthesia and non-opioid medications, is recommended.
- Transdermal buprenorphine shows promise for managing acute perioperative pain.
- Transdermal delivery may improve adherence and pain control.
Conclusions:
- Continuing home buprenorphine doses perioperatively is recommended.
- A multimodal approach enhances pain management for patients on buprenorphine.
- Transdermal buprenorphine presents a valuable option for perioperative pain management in orthopaedics.
More Related Videos
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
275
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
275
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
231
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
231
01:25Analgesia and Pain Management
575
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
575
01:02Prescription, Nonprescription and Orphan Drugs
719
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
719
01:22Opioid Receptors: Overview
714
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
714
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
189
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
189