ReviewA Practical Approach for the Management of the Mixed Opioid Agonist-Antagonist Buprenorphine During Acute Pain and Surgery
Section snippets
Methods
Similar to previously published search strategies,13,14 databases of MEDLINE using the PubMed and Ovid platforms were searched using the key words buprenorphine, acute pain, surgery, preoperative, postoperative, perioperative, and discontinuation with no date restrictions. Key words pertaining to specific topics (eg, OUD, acute postoperative pain management, buprenorphine pharmacology, and opioid tapering) were cross-referenced with the initial search terms using the identified databases.
Conclusion
Buprenorphine use is increasingly common, and medical providers must be adequately prepared to manage these patients in both elective and emergent situations. The three domains to consider when confronted with the patient on buprenorphine who presents for surgery or acute pain include the patient, the features of the acute pain insult, and the environment. In general, patients undergoing procedures with low anticipated opioid requirements may continue buprenorphine therapy. Similarly, those
Acknowledgments
The authors thank Dr. Nuria Thusius (Department of Psychiatry, Mayo Clinic) for her expertise and assistance with this manuscript, particularly regarding the implications for those on buprenorphine for OUD. The manuscript is dedicated in her loving memory.
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Potential Competing Interests: Dr N.S. Warner receives research support from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. Dr M.A. Warner receives research support from the Clinical and Translational Sciences Award (CTSA) Grant Number KL2 TR002379 from the National Center for Advancing Translational Sciences (NCATS). The remaining authors report no competing interests.