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Methadone or Buprenorphine: Equal in Treating Opioid Dependent Parturients?
Cindi Dabney1, Nicole Nelson2, Michelle Canale3
1Assistant Professor at the University of South Florida, Tampa, Florida.
AANA Journal
|October 7, 2025
Summary
Opioid use disorder in pregnant patients affects nearly 6 in 1000 births. This review details buprenorphine and methadone management for expecting mothers, crucial for anesthesia and obstetrical teams.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pharmacology
Background:
- Opioid use disorder (OUD) in pregnant patients affects approximately 6 in 1000 births, leading to significant healthcare costs.
- Current management guidelines recommend buprenorphine and methadone for OUD in pregnancy.
- The differing pharmacology of these medications presents challenges in initiation and management.
Purpose of the Study:
- To describe the pharmacological differences between buprenorphine and methadone.
- To discuss the benefits and limitations of using buprenorphine and methadone in parturients.
- To provide evidence-based practice guidance for managing pregnant patients with OUD.
Main Methods:
- Literature review of current research data on buprenorphine and methadone in parturients.
- Comparative analysis of the pharmacology of buprenorphine and methadone.
- Discussion of clinical management strategies based on existing evidence.
Main Results:
- Buprenorphine and methadone exhibit distinct pharmacological profiles.
- Both medications have specific benefits and limitations for use in pregnant patients.
- Understanding these differences is vital for effective patient care.
Conclusions:
- Anesthesia providers and obstetrical teams require a comprehensive understanding of buprenorphine and methadone for managing OUD in pregnancy.
- Evidence-based practice is essential for optimizing outcomes for both mother and infant.
- Further research may elucidate optimal management strategies.
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