Education  |   June 2017
To Stop or Not, That Is the Question: Acute Pain Management for the Patient on Chronic Buprenorphine
Author Notes
  • Department of Anesthesia, Critical Care and Pain Medicine (T.A.A., A.N.A.Q.), and Department of Psychiatry (E.N.W., T.E.W.), Massachusetts General Hospital, Boston, Massachusetts; and Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (P.E.H., C.M.B.).
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • Figures 1 and 2 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.
    Figures 1 and 2 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.×
  • Submitted for publication May 1, 2016. Accepted for publication February 3, 2017.
    Submitted for publication May 1, 2016. Accepted for publication February 3, 2017.×
  • Address correspondence to Dr. Anderson: 55 Fruit Street, GRJ 409, Boston, Massachusetts 02114. tanderson9@mgh.harvard.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Clinical Concepts and Commentary / Pain Medicine
Education   |   June 2017
To Stop or Not, That Is the Question: Acute Pain Management for the Patient on Chronic Buprenorphine
Anesthesiology 6 2017, Vol.126, 1180-1186. doi:10.1097/ALN.0000000000001633
Anesthesiology 6 2017, Vol.126, 1180-1186. doi:10.1097/ALN.0000000000001633
The management of acute perioperative pain in patients on chronic buprenorphine as opioid maintenance therapy is a complex process. We describe pain management approaches for patients on buprenorphine who present for elective and urgent/emergent surgery.
Opioid use disorder, a chronic neurobehavioral disease, is difficult to manage and accompanied by extensive psychologic and physical comorbidity, as well as a high mortality rate, when untreated.1  Over the past two decades, opioid-related deaths and admission to treatment facilities have risen substantially. Of the 21.5 million Americans experiencing substance use disorders in 2014, an estimated 1.9 million had opioid use disorder, and more than 0.5 million were addicted to heroin.2  Similarly, the number of patients on medication-assisted treatment is on the rise.
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