Katelynn Champagne1, Preshita Date1, Juan Pablo Forero2, Joshua Arany3, Karina Gritsenko4,5. 1. Department of Anesthesiology, Montefiore Medical Center, 111 East 210th St, Bronx, NY, 10467, USA. 2. Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. 3. Townsend Harris High School, 149-11 Melbourne Ave, Flushing, NY, 11367, USA. 4. Department of Anesthesiology, Montefiore Medical Center, 111 East 210th St, Bronx, NY, 10467, USA. kgritsen@montefiore.org. 5. Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. kgritsen@montefiore.org.
Abstract
PURPOSE OF REVIEW: To review the pharmacology of buprenorphine, the evolution of buprenorphine dosing recommendations, and the current literature regarding its recommendations for the perioperative period. RECENT FINDINGS: There is a consensus that for all surgeries, buprenorphine should be continued throughout the perioperative period. If the surgery is a minimal to mild pain surgery, no dose adjustment is needed. There is no clear consensus regarding moderate to severe pain. With all surgeries, multimodal analgesia should be utilized, with regional anesthesia when possible. Patients taking buprenorphine should continue their buprenorphine perioperatively; whether to decrease or maintain dosing is up for debate. Multimodal analgesia should also be used throughout the perioperative period, and communication between the patient and all provider teams is of the utmost importance to provide adequate analgesia during the perioperative period, as well as to arrange safe analgesia upon discharge.
PURPOSE OF REVIEW: To review the pharmacology of buprenorphine, the evolution of buprenorphine dosing recommendations, and the current literature regarding its recommendations for the perioperative period. RECENT FINDINGS: There is a consensus that for all surgeries, buprenorphine should be continued throughout the perioperative period. If the surgery is a minimal to mild pain surgery, no dose adjustment is needed. There is no clear consensus regarding moderate to severe pain. With all surgeries, multimodal analgesia should be utilized, with regional anesthesia when possible. Patients taking buprenorphine should continue their buprenorphine perioperatively; whether to decrease or maintain dosing is up for debate. Multimodal analgesia should also be used throughout the perioperative period, and communication between the patient and all provider teams is of the utmost importance to provide adequate analgesia during the perioperative period, as well as to arrange safe analgesia upon discharge.
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