Yasmin Sritapan, Sean Clifford, Alexander Bautista
The opioid epidemic has emerged as a major health and social problem over the last few decades. An increasing number of patients with opioid use disorder are presenting for perioperative management. These patients are either on buprenorphine or methadone for the maintenance and treatment of opioid addiction or chronic pain. In the settings of acute pain, the optimal management of patients with opioid use disorder is challenging, and recovery can be jeopardized secondary to the unique pharmacology of these agents...
August 11, 2020: Balkan Medical Journal
Akash Goel, Saam Azargive, Joel S Weissman, Harsha Shanthanna, John G Hanlon, Bana Samman, Mary Dominicis, Karim S Ladha, Wiplove Lamba, Scott Duggan, Tania Di Renna, Philip Peng, Clinton Wong, Avinash Sinha, Naveen Eipe, David Martell, Howard Intrater, Peter MacDougall, Kwesi Kwofie, Mireille St-Jean, Saifee Rashiq, Kari Van Camp, David Flamer, Michael Satok-Wolman, Hance Clarke
Until recently, the belief that adequate pain management was not achievable while patients remained on buprenorphine was the impetus for the perioperative discontinuation of buprenorphine. We aimed to use an expert consensus Delphi-based survey technique to 1) specify the need for perioperative guidelines in this context and 2) offer a set of recommendations for the perioperative management of these patients. The major recommendation of this practice advisory is to continue buprenorphine therapy in the perioperative period...
August 2019: British Journal of Anaesthesia
Aurora Naa-Afoley Quaye, Yi Zhang
OBJECTIVE: There is no consensus on the optimal perioperative management of patients on buprenorphine (BUP) for opioid use disorder (OUD). This article will review the available literature on BUP and the analgesic efficacy of BUP combined with full mu-opioid agonists and discuss the conflicting management strategies in the context of acute pain and our institution's protocol for the periprocedural management of BUP. METHODS: We searched published data on BUP periprocedural management from inception through March 2018 without language restrictions...
July 1, 2019: Pain Medicine
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