Sublingual Buprenorphine/Naloxone and Multi-Modal Management for High-Risk Chronic Pain Patients

Kaski, Shane W; Marshalek, Patrick; Herschler, Jeremy; Wen, Sijin; Wang, Zheng

doi:10.3390/jcm10050973

Cited by 2 publications

(1 citation statement)

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“…Buprenorphine is generally used to treat OUD, but it is a promising alternative to standard opioids for patients who both have concurrent chronic pain and an OUD or high-risk opioid use behavior. The findings of the present study support the use of buprenorphine/naloxone as a safe and efficient component of comprehensive pain therapy in these patients, with the benefit of close to six years of monitoring [20].…”

Section: Summary Of Findingssupporting

confidence: 74%

The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

Patel,

Lee,

Witherspoon

et al. 2024

Cureus

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Although research suggests that less than half of individuals who have surgical procedures report effective postoperative pain alleviation, the majority of patients endure acute postoperative discomfort. To lessen and manage postoperative pain, a variety of preoperative, intraoperative, and postoperative treatments and management methods are available. For several years an opioid called buprenorphine has become an effective tool to treat opioid use disorder (OUD) in patients across many different demographics. It has however endured barriers to its usage which can be seen when treating patients with chronic pain or postoperative pain, who also have an OUD. While buprenorphine may be underutilized within the clinical setting, the significantly low rates of chronic abuse when using the drug allow it to be an attractive treatment option for patients. This paper aims to explore a wide range of studies that examine buprenorphine as an analgesic and how it can be used for preoperative pain and postoperative pain. This paper will give an in-depth analysis of buprenorphine and its use in patients with chronic pain as well as OUD.A systematic literature review was performed by identifying studies through the database PubMed. The data from various publications were gathered with preference being given to publications within the last three years. We reviewed studies that examined the pain level of the patients after having buprenorphine.Despite long-available pharmacologic evidence and clinical research, buprenorphine has maintained a mystique as an analgesic. Its usage in the treatment of OUD was further influenced by its well-known safety benefits and relative lack of psychomimetic side effects compared to other opioids. For patients accustomed to long-term, high-dose opioids who may be experiencing hyperalgesia but have not been informed about this phenomenon by their doctors or the potential for buprenorphine to resolve it, buprenorphine's pronounced antihyperalgesic effect is a compelling pharmacologic characteristic that makes it particularly attractive as an option.When used in pre-, peri-, and postoperative circumstances, buprenorphine provides various painmanagement benefits and patients can still benefit from effective pain management from mu-opioid agonists while remaining on buprenorphine.Buprenorphine can be continued at a reduced dose as needed to avoid withdrawal symptoms and to improve the analgesic efficiency of mu-opioid agonists used in combination with acute postoperative pain in light of the evidence at hand. Buprenorphine administration needs a patient-centered, multidisciplinary strategy that considers the benefits and drawbacks of the many perioperative therapy options to have the best chance of success.

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Section: Summary Of Findingssupporting

confidence: 74%