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The perioperative patient on buprenorphine: A systematic review of perioperative management strategies and patient outcomes

Canadian Journal of Anesthesia Dec 01, 2018

Goel A, et al. - Given that perioperative mismanagement of patients on buprenorphine/naloxone pose a significant risk to the long-term health of these patients, researchers focused on the strategies and outcomes for perioperative management of patients on buprenorphine in this systematic review. Evidence from 18 studies, including one controlled study and 4 observational studies, was analyzed. These studies were identified from Medline, Medline In-Process, Embase, Cochrane Central, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science (Clarivate), Scopus (Elsevier), CINAHL (EbscoHosst), and PubMed (NLM). No evidence against continuing buprenorphine perioperatively was obtained from observational studies and case reports, this was reported especially when the dose was < 16 mg sublingually (SL) daily. Buprenorphine discontinuation should have a strong rationale supported by patient and surgical preferences in patients with significant potential for relapse, such as those with a recent history of opioid use disorder (OUD).
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