Perioperative Pain Management and Buprenorphine

Opioid addiction is an increasing problem with a higher prevalence of buprenorphine being prescribed for withdrawal and maintenance therapy. Opioids have a decreased ability to relieve pain in patients taking buprenorphine.1 Few case reports exist discussing the best pain relieving options for patients on this medication. There are suggestions for the use of non-opioid alternatives with little documentation of real events. Presented are the perioperative events of a patient taking buprenorphine for opioid addiction maintenance. Anesthesia practitioners must recognize and understand the effects of this medication and be prepared to incorporate alternatives to opioids in the perioperative plan.