Management of Patients on Medications for Opioid Use Disorder in the Perioperative or Peripartum Setting

There is an increasing proportion of surgical and obstetric patients on medications for the treatment of opioid use disorder (medications for opioid use disorder [MOUD]), formerly known as medication-assisted treatment, in the United States. Due to lack of institutional protocols and limited evidence-based guidelines, perioperative management of patients on MOUD has largely been varied and often provider-dependent. This article explores the current evidence and recommendations for perioperative and peripartum management of patients on buprenorphine, methadone, and naltrexone; as well as key principles for optimizing perioperative and peridelivery pain management.