Evaluating the use of sublingual sufentanil in patients with buprenorphine treatment who are undergoing ambulatory surgery: A Prospective Case Report
- PMID: 39717831
- PMCID: PMC11663685
- DOI: 10.52965/001c.124776
Evaluating the use of sublingual sufentanil in patients with buprenorphine treatment who are undergoing ambulatory surgery: A Prospective Case Report
Abstract
Introduction: Opioid use disorder is a chronic illness with significant morbidity and mortality. Opioid agonists, like buprenorphine, are commonly used to prevent relapse. Recent changes in buprenorphine legislation are expected to increase prescription and guidelines recommend its continuation during the perioperative period for many patients. However, buprenorphine's strong affinity for mu receptors can complicate perioperative pain management, requiring high doses of analgesics and increasing risks like respiratory depression. A newly FDA-approved sublingual sufentanil system, with higher mu receptor affinity, may offer a solution.
Case presentation: A series of three cases with patients undergoing outpatient surgery procedures while continuing buprenorphine treatment are presented.
Management and outcomes: Sublingual sufentanil was effective in lowering pain with no adverse effects for the buprenorphine patients undergoing surgery with general anesthesia without a missed dose.
Conclusion: Further research is needed to make conclusive remarks on the efficacy of this treatment, but the quick onset and effective treatment make this route worthwhile to consider.
Keywords: acute pain; buprenorphine; mu receptor; post-op pain; suboxone; sufentanil.
Conflict of interest statement
All authors except Dr. Naum Shaparin and Dr. Karina Gritsenko report no disclosures. Dr. Naum Shaparin reports receiving research funding from AcelRx Pharmaceuticals, Averitas Pharma, and Heron Therapeutics. Dr. Karina Gritsenko reports being a consultant for Pacira Biosciences and Grunenthal Pharmaceuticals.
References
-
- To Stop or Not, That Is the Question: Acute Pain Management for the Patient on Chronic Buprenorphine. Anderson T. A., Quaye A. N. A., Ward E. N., Wilens T. E., Hilliard P. E., Brummett C. M. 2017Anesthesiology. 126(6):1180–1186. doi: 10.1097/ALN.0000000000001633. https://doi.org/10.1097/ALN.0000000000001633 - DOI - DOI - PMC - PubMed
-
- Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies. Degenhardt L., Bucello C., Mathers B., Briegleb C., Ali H., Hickman M., McLaren J. 2011Addiction (Abingdon, England) 106(1):32–51. doi: 10.1111/j.1360-0443.2010.03140.x. https://doi.org/10.1111/j.1360-0443.2010.03140.x - DOI - DOI - PubMed
-
- Buprenorphine: considerations for pain management. Johnson R. E., Fudala P. J., Payne R. 2005Journal of Pain and Symptom Management. 29(3):297–326. doi: 10.1016/j.jpainsymman.2004.07.005. https://doi.org/10.1016/j.jpainsymman.2004.07.005 - DOI - DOI - PubMed
-
- Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Alford D. P., Compton P., Samet J. H. 2006Annals of InternalMedicine. 144(2):127–134. doi: 10.7326/0003-4819-144-2-200601170-00010. https://doi.org/10.7326/0003-4819-144-2-200601170-00010 - DOI - DOI - PMC - PubMed
-
- Clemans-Cope L., Lynch V., Winiski E., Epstein M. State Variation in Medicaid Prescriptions for Opioid Use Disorder from 2011 to 2018. Urban Institute;
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