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Review
. 2022 Jan;106(1):169-185.
doi: 10.1016/j.mcna.2021.09.001.

Perioperative Buprenorphine Management: A Multidisciplinary Approach

Thomas Hickey  1 , Audrey Abelleira  2 , Gregory Acampora  3 , William C Becker  4 , Caroline G Falker  2 , Mitchell Nazario  5 , Melissa B Weimer  6
Affiliations
Review

Perioperative Buprenorphine Management: A Multidisciplinary Approach

Thomas Hickey et al. Med Clin North Am. 2022 Jan.

Abstract

Buprenorphine formulations (including buprenorphine/naloxone) are effective treatments of pain and opioid use disorder (OUD). Historically, perioperative management of patients prescribed buprenorphine involved abstinence from buprenorphine sufficient to allow for unrestricted mu-opioid receptor availability to full agonist opioid (FAO) treatment. Evidence is mounting that a multimodal analgesic strategy, including simultaneous administration of buprenorphine and FAO, nonopioid adjuncts such as acetaminophen and nonsteroidal anti-inflammatory drugs, and regional anesthesia, is a safe and effective perioperative strategy for the patient prescribed long-term buprenorphine treatment of OUD. This strategy will likely simplify management and more seamlessly provide continuous buprenorphine treatment of OUD after hospital discharge.

Keywords: Analgesia; Buprenorphine; Opioid-related disorders; Pain; Partial opioid agonists; Postoperative.

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Conflict of interest statement

Disclosure Dr M.B. Weimer discloses an advisory role with Path CCM, Inc. The other authors have nothing to disclose. The views and opinions of authors expressed herein do not necessarily state or reflect those of the US government or any agency thereof.

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