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Perioperative Management of Patients on Buprenorphine and Methadone: A Narrative Review

Balkan Med J. 2020 Aug 11;37(5):247-252. doi: 10.4274/balkanmedj.galenos.2020.2020.5.2. Epub 2020 May 14.

Abstract

The opioid epidemic has emerged as a major health and social problem over the last few decades. An increasing number of patients with opioid use disorder are presenting for perioperative management. These patients are either on buprenorphine or methadone for the maintenance and treatment of opioid addiction or chronic pain. In the settings of acute pain, the optimal management of patients with opioid use disorder is challenging, and recovery can be jeopardized secondary to the unique pharmacology of these agents. The purpose of this narrative review is to summarize the existing studies on the perioperative management of patients who are using buprenorphine and methadone and provide guidance for the management of patients with opioid use disorder during the perioperative period.

Keywords: Buprenorphine; chronic pain; methadone; opioid use disorder; perioperative management; surgery.

Publication types

  • Review

MeSH terms

  • Buprenorphine / adverse effects*
  • Buprenorphine / pharmacology
  • Buprenorphine / therapeutic use
  • Humans
  • Methadone / adverse effects*
  • Methadone / pharmacology
  • Methadone / therapeutic use
  • Pain Management / adverse effects
  • Pain Management / methods*
  • Perioperative Care / methods*
  • Perioperative Care / trends

Substances

  • Buprenorphine
  • Methadone