Continuing Chronic Buprenorphine Perioperatively is Associated With Reduced Postoperative Opioid Use

Introduction: Buprenorphine is a frequently used medication for opioid use disorder and misunderstanding buprenorphine's unique pharmacology has historically complicated peri-operative analgesia. The purpose of this study was to evaluate the association of perioperative buprenorphine continuation in patients with substance use disorder on perioperative opioid use.Materials and methods: This was a single-center retrospective study at a level 1 trauma ac-ademic medical center. Adult patients using outpatient buprenorphine for medication for opioid use disorder admitted with an operating room booking were included. Patients were grouped (continuation, withheld) retrospectively based upon the decision to continue or omit buprenorphine therapy while admitted. The primary outcome of the study was any use of full mu-opioid agonists during days 1-7 of admission. Secondary outcomes included length of stay and average pain scores during days 1-7 of admission.Results: 43.4% of patients in the continuation cohort used no full mu-opioid agonists during days 1-7 compared to 3.1% of patients in the withheld cohort (P < 0.001). No significant difference in median length of stay was noted (4.7 d [2.8-6.6] versus 6.1 d [4.0-8.2], P = 0.36). There was no statistical difference in average pain scores on postoperative days 1 (5.2 versus 6.9, P = 0.82) and 7 (0 versus 0, P = 0.41).Conclusions: Perioperative continuation of buprenorphine is associated with reduced use of alternative full mu-opioid agents while admitted without impacting pain scores.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study evaluated the impact of perioperative continuation of buprenorphine on the use of opioid medications in patients with substance use disorder. The results showed that 43.4% of patients who continued buprenorphine did not use opioid medications during days 1-7 of admission, compared to only 3.1% of patients who withheld buprenorphine. The study concluded that perioperative continuation of buprenorphine reduces the use of opioid medications without affecting pain scores.