Buprenorphine and Cardiac Surgery: Navigating the Challenges of Pain Management

Document Type

Article

Publication Date

9-1-2022

Publication Title

Journal of cardiothoracic and vascular anesthesia

Abstract

Over the last two decades, buprenorphine has been used for the treatment of pain, opioid addiction, and detoxification. It has unique properties, including partial agonist activity at the mu receptor, while also exhibiting antagonism at the kappa receptor. The half-life is highly variable with each patient, but it may extend up to 60 hours. In addition, even low doses will outcompete other opioids to bind receptors, rendering other opioids ineffective unless very high doses are used. Although this may be advantageous in the outpatient setting, the pharmacokinetic and pharmacodynamic properties of buprenorphine can complicate the perioperative management of pain when these patients present for surgery. Herein, the authors present a case during which a patient who was started on buprenorphine for addiction therapy was referred subsequently for cardiac surgery during the same inpatient hospital admission.

Medical Subject Headings

Analgesics, Opioid; Buprenorphine; Cardiac Surgical Procedures; Humans; Nerve Block; Pain Management; Pain, Postoperative

PubMed ID

35667956

Volume

36

Issue

9

First Page

3701

Last Page

3708

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