New Pain Management Options for the Surgical Patient on Methadone and Buprenorphine

被引:38
作者
Sen, Sudipta [1 ]
Arulkumar, Sailesh [1 ]
Cornett, Elyse M. [1 ]
Gayle, Julie A. [2 ]
Flower, Ronda R. [2 ]
Fox, Charles J. [1 ]
Kaye, Alan D. [2 ,3 ]
机构
[1] LSUHSC Shreveport, Dept Anesthesiol, Shreveport, LA USA
[2] LSUHSC New Orleans, Dept Anesthesiol, New Orleans, LA USA
[3] Louisiana State Univ, Hlth Sci Ctr, Dept Anesthesiol, 1542 Tulane Ave, New Orleans, LA 70112 USA
关键词
Methadone; Buprenorphine; Pain; Patient-controlled analgesia; Analgesia; Opiates; Drug abuse; Pregnancy; POSTOPERATIVE PAIN; CLINICAL PHARMACOKINETICS; ANALGESIA; EPIDEMIOLOGY; ADDICTION; MORPHINE;
D O I
10.1007/s11916-016-0549-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Perioperative management of patients receiving opioid addiction therapy presents a unique challenge for the anesthesiologist. The goal of pain management in this patient population is to effectively manage postoperative pain, to improve patient satisfaction and outcomes, and to reduce the cost of health care. Multimodal analgesics, including nonsteroid anti-inflammatory drugs, intravenous acetaminophen, gabapentanoid agents, and low-dose ketamine infusions, have been used to improve postoperative pain and to reduce postoperative opioid use. Patients on long-term opioid management therapy with methadone and buprenorphine require special considerations. Recommendations and options for treating postoperative pain in patients on methadone and buprenorphine are outlined below. Other postoperative pain management options include patient-controlled analgesia, intravenous, and transdermal, in addition to neuraxial and regional anesthesia techniques. Special patient populations include the parturient on long-term opioid therapy. Recommendations for use of opioids in these patients during labor and delivery and in the postpartum period are discussed.
引用
收藏
页码:1 / 8
页数:8
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