Erin M. Foley
© 2020 Coreen Tanner
According to the US Department of Health and Human Services, more than 2 million Americans suffer from opioid use disorder (DHHS, 2020). Opioid maintenance therapy (OMT) for OUD has been shown to reduce the rates of inpatient hospitalization and overall opioid-related mortality (Quaye & Zhang, 2019). Buprenorphine is a partial mu receptor agonist and kappa receptor antagonist that is used frequently by patients on OMT. Beginning in 2010 annual prescriptions for buprenorphine products have increased dramatically (Lembke, Ottestad, & Schmiesing, 2019).
With the rising level of chronic pain and opioid use nationally, more and more patients taking buprenorphine are presenting to the perioperative setting. The pharmacology of buprenorphine presents a unique challenge to the anesthesia provider particularly with regards to achieving adequate pain control during and after surgery. A review of the literature indicates that there are no unified guidelines on the perioperative management of buprenorphine. The focus of this paper is to discuss the unique pharmacology of buprenorphine and review the current literature on the best perioperative management strategies for patients on buprenorphine. The case study included provides an example of one patient’s perioperative experience while on buprenorphine.
Tanner, Coreen, "Current Recommendations For The Perioperative Management Of Patients On Buprenorphine: A Case Study" (2020). Nurse Anesthesia Capstones. 31.