Acute Pain Management for Patients Maintained on Sublingual Buprenorphine as Medication for Opioid Use Disorder

Objective The aim of this study was to compare morphine milligram equivalent (MME) requirements for acute pain management between patients admitted for medical or surgical diagnoses with opioid use disorder (OUD) who receive >12 mg of sublingual buprenorphine daily compared with those who receive <= 12 mg/d.Design This study was performed via retrospective chart review.Setting This study evaluated patient encounters between January 2017 and November 2021 from a single-center community teaching hospital in Lancaster, PA.Methods Patients were assessed according to daily dose of buprenorphine received while admitted (>12 mg/d vs <= 12 mg/d); patients who had buprenorphine held were included within the <= 12 mg/d study group. The primary outcome evaluated daily average MME requirements over the entirety of hospital length of stay. Key secondary outcomes were total MME requirements and daily average pain scores.Subjects Key inclusion criteria were sublingual buprenorphine therapy for at least 1 month prior to admission, presence of an acute pain diagnosis during hospital stay, and history of OUD.Results Seventy-eight (78) patients were included for analysis. Daily average MME requirements were similar between patients who received buprenorphine >12 mg/d and <= 12 mg/d (median, 7.5 vs 10.6; P = 0.350). Total MME and daily average pain scores were similar between study groups.Conclusions For OUD patients in need of acute pain management, the continuation of sublingual buprenorphine throughout hospitalization at a daily dose of >12 mg/d compared with <= 12 mg/d did not confer a significant difference in daily average MME requirements.