Establishing Buprenorphine for Acute Postoperative Pain Management

Area of Science:

• Anesthesiology
• Pain Management
• Pharmacology

Background:

• Opioids are standard for postoperative pain but cause significant harms, including overdose.
• Buprenorphine, a partial opioid agonist, was developed for analgesia but is known for opioid use disorder treatment.
• There is growing interest in using buprenorphine for perioperative pain management.

Purpose of the Study:

• To review the harms of full agonist opioids in postoperative pain.
• To highlight the efficacy and safety benefits of buprenorphine over usual care opioids.
• To describe the institutional implementation of buprenorphine buccal film for perioperative pain.

Main Methods:

• Review of literature on opioid use and buprenorphine.
• Description of institutional process for adopting buprenorphine buccal film.
• Details on staff training, order set development, and included surgical populations.

Main Results:

• Buprenorphine presents a promising strategy to mitigate opioid-related harms.
• The buccal film formulation of buprenorphine offers distinct advantages for perioperative use.
• Implementation involved staff training and specific order sets for selected surgical groups.

Conclusions:

• Buprenorphine holds potential for reducing postoperative opioid harms while enhancing pain management.
• The buccal formulation demonstrates unique benefits for perioperative administration.
• Further research is needed to fully understand buprenorphine's impact on pain and opioid outcomes.