Hickey Thomas, Abelleira Audrey, Acampora Gregory, Becker William C, Falker Caroline G, Nazario Mitchell, Weimer Melissa B
VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Anesthesiology, Yale School of Medicine, 950 Campbell Avenue, West Haven, CT 06516, USA.
VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA.
Med Clin North Am. 2022 Jan;106(1):169-185. doi: 10.1016/j.mcna.2021.09.001.
Buprenorphine formulations (including buprenorphine/naloxone) are effective treatments of pain and opioid use disorder (OUD). Historically, perioperative management of patients prescribed buprenorphine involved abstinence from buprenorphine sufficient to allow for unrestricted mu-opioid receptor availability to full agonist opioid (FAO) treatment. Evidence is mounting that a multimodal analgesic strategy, including simultaneous administration of buprenorphine and FAO, nonopioid adjuncts such as acetaminophen and nonsteroidal anti-inflammatory drugs, and regional anesthesia, is a safe and effective perioperative strategy for the patient prescribed long-term buprenorphine treatment of OUD. This strategy will likely simplify management and more seamlessly provide continuous buprenorphine treatment of OUD after hospital discharge.
丁丙诺啡制剂（包括丁丙诺啡/纳洛酮）是疼痛和阿片类物质使用障碍（OUD）的有效治疗方法。从历史上看，对服用丁丙诺啡的患者进行围手术期管理时，需要停用丁丙诺啡足够长的时间，以使μ-阿片受体能够不受限制地用于全激动剂阿片类药物（FAO）治疗。越来越多的证据表明，多模式镇痛策略，包括同时使用丁丙诺啡和FAO、对乙酰氨基酚和非甾体类抗炎药等非阿片类辅助药物以及区域麻醉，对于长期服用丁丙诺啡治疗OUD的患者来说是一种安全有效的围手术期策略。这种策略可能会简化管理，并在出院后更无缝地提供对OUD的持续丁丙诺啡治疗。
