Use of Buprenorphine for Cancer Related Pain in Pregnancy

Document Type

Conference Proceeding

Publication Date

5-1-2024

Publication Title

J Pain Symptom Manage

Abstract

Outcomes: 1. Participants will be able to recognize buprenorphine as a safe and effective analgesic for cancer pain in pregnancy. 2. Participants will be able to integrate buprenorphine into more facets of clinical practice in treatment of cancer-related pain.

Key Message: There is paucity of literature describing the treatment of cancer associated pain in pregnancy. Buprenorphine is an increasingly recognized analgesic used to treat cancer pain with an established safety profile studied in maternal opioid use disorder (OUD). We present a case demonstrating the safe and efficacious use of buprenorphine for cancer-related pain in a pregnant woman with a pancreatic neoplasm.

Abstract: Opioids often are utilized for the optimization of cancer related pain; however, managing cancer-related pain in pregnancy can present challenges, particularly due to opioid-related risks to the fetus in utero. In addition, there is a paucity of literature with regard to treating cancer related pain in pregnancy. Here we present a case where buprenorphine was successfully used to manage cancer related pain for a pregnant female. We present a case of a 36-year-old G3P2 female diagnosed with metastatic solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas at 27 weeks gestation. She began experiencing severe nociceptive visceral abdominal pain, which impaired her ability to perform activities of daily living and even sleep throughout the night. She was started on very low doses of buprenorphine (partial Suboxone SL films), three times a day with improved pain control, physical functioning and sleep with minimal to no side effects. Labor was induced at 34 weeks secondary to intrauterine growth restriction and oligohydramnios, with APGAR scores 8/8 at birth. Buprenorphine was continued for pain control postpartum at varying doses, compatible with patient's wish to continue to breastfeed with appropriate analgesia. Buprenorphine is becoming increasingly more recognized for its efficacy in treating cancer-related pain. The literature describing buprenorphine for pain management in pregnancy is limited; however, its use in treating opioid use disorder in pregnancy and fetal safety profile is well understood. In presenting this case, we demonstrate the safe and efficacious utility of buprenorphine for cancer-related pain during pregnancy.

Volume

67

Issue

5

First Page

e755

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