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Guidelines for the use of buprenorphine for opioid use disorder in the perioperative setting
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  1. Lynn Kohan1,
  2. Sudheer Potru2,
  3. Antje M Barreveld3,
  4. Michael Sprintz4,
  5. Olabisi Lane5,
  6. Anuj Aryal6,
  7. Trent Emerick7,
  8. Anna Dopp8,
  9. Sophia Chhay8 and
  10. Eugene Viscusi9
  1. 1 Divsion of Pain Medicine/Department of Anesthesia, University of Virginia, Charlottesville, Virginia, USA
  2. 2 Department of Anesthesiology/Division of Pain Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
  3. 3 Department of Anesthesiology, Tufts University School of Medicine, Boston, Massachusetts, USA
  4. 4 Division of Geriatrics and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  5. 5 Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA
  6. 6 Department of Anesthesiology, VA Tennessee Valley Healthcare System Nashville Campus, Nashville, Tennessee, USA
  7. 7 Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  8. 8 American Society Health System Pharmacists, Bethesda, Maryland, USA
  9. 9 Department of Anesthesiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Sudheer Potru, Atlanta VA Medical Center, Emory University School of Medicine, Atlanta, Georgia, USA; sudheer.potru{at}emory.edu

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Abstract

The boards of directors of the American Society of Regional Anesthesia and Pain Medicine, American Society of Anesthesiologists, American Academy of Pain Medicine, American Society of Addiction Medicine and American Society of Health System Pharmacists approved the creation of a Multisociety Working Group on Opioid Use Disorder (OUD), representing the fields of pain medicine, addiction and pharmacy health sciences. An extensive literature search was performed, and a modified Delphi process was used to assess the literature and expert opinion for each topic, with 100% consensus being achieved on the statements and each recommendation. The consensus statements were then graded by the committee members using the US Preventive Services Task Force grading of evidence guidelines. Two core topics were identified for the development of recommendations, with both topics achieving 100% consensus: (1) providing recommendations to aid physicians in the management of patients receiving buprenorphine for medication treatment of OUD in the perioperative setting and (2) providing recommendations to aid physicians in the initiation of buprenorphine in patients with suspected OUD in the perioperative setting. To decrease the risk of OUD recurrence, buprenorphine should not be routinely discontinued in the perioperative setting. Buprenorphine can be initiated in untreated patients with OUD and acute pain in the perioperative setting to decrease the risk of opioid recurrence and death from overdose.

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Footnotes

  • Twitter @kohanlynn, @SPotruDO

  • Contributors All authors participated in development of the original manuscript on which this infographic was created. LK authored the infographic.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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