Perioperative opioid requirements of patients receiving sublingual buprenorphine-naloxone: a case series

Martin, Yvette N.; Deljou, Atousa; Weingarten, Toby N.; Schroeder, Darrell R.; Sprung, Juraj

doi:10.1186/s12871-019-0745-3

BMC Anesthesiology

Table 1 Anesthetic and surgical characteristics and opioid requirements of patients taking buprenorphine-naloxone (SL-BUP) who underwent surgical procedures with regional anesthesia only or combined general/regional anesthesia

From: Perioperative opioid requirements of patients receiving sublingual buprenorphine-naloxone: a case series

Pt	SL-BUP Administration		Procedure (Anesthetic Agents) Year of Surgery	Regional Anesthesia Type and Drugs	Surgery Time, min	Opioid Administration, IV-MEq				Highest VNPS^¶
Pt	Daily SL-BUP Dose, mg^†	Days without SL-BUP^a	Procedure (Anesthetic Agents) Year of Surgery	Regional Anesthesia Type and Drugs	Surgery Time, min	Intra- operative	PACU Only	24 h after PACU Discharge	Total IV-MEq^§	Highest VNPS^¶
Regional Anesthesia Only
1	8 (2)	0	Cesarean section, 2012	Spinal^b (Bupiv+Fentanyl)	57	12	74	133	219*	10^c
2	8 (2)	0	Minor vascular, 2010	Axillary^b (Mepiv)	127	5	0	0	5	NR
3	16 (4)^e	2	Major orthopedic, 2016	Spinal^b (Bupiv)	94	15	0	74	89	9^c
Combined Regional + General Anesthesia
1	2 (0.5)^e	0	Thoracic (Iso), 2009	Epidural^d (Bupiv+Hydromor)	110	39	30	134	203^*	10
2	4 (1)	0	Major orthopedic (Iso + N₂O), 2014	Interscalene^f (Bupiv+Clon)	93	30	18	53	100^‡	9
3	16 (4)^e	0	Major orthopedic (Iso + N₂O), 2014	Interscalene (Bupiv+Clon)	70	15	20	38	73	8
4	16 (4)	0	Minor orthopedic (Pro), 2013	Axillary^b (Bupiv)	88	5	0	0	5	NR
5	16 (4)	0	Major orthopedic (Sevo+N₂O), 2015	Femoral^f (Bupiv)	168	40	10	94	143^*	10^c
6	24 (6)	0	Major orthopedic (Iso + N₂O), 2014	Interscalene^f (Bupiv)	60	5	13	420	437	9
7	32 (8)	0	Major orthopedic (Iso + N₂O), 2011	Epidural^d (Bupiv)	128	13	5	60	78^*	8^c
8	24 (6)	2	Major orthopedic (Des), 2011	Psoas^e (Bupiv)	74	10	40	0	50	4^c
9	24 (6)	2	Major orthopedic (Des), 2012	Sciatic^d + femoral^d (Bupiv)	124	53	15	33	100	8
10	4 (1)	4	Major orthopedic (Iso + N₂O), 2012	Interscalene^f (Bupiv)	120	40	8	110	157	10^c
11	16 (4)^e	7	Abdominal (Iso), 2014	Spinal^f (Hydromor)	115	20	15	105	140^*	10^c
12	24 (6)^e	30	Major orthopedic (Iso), 2013	Interscalene^f (Bupiv)	93	25	0	241	266	10

Abbreviations: IV-MEq intravenous morphine equivalent; NR not reported; PACU post-anesthesia care unit; SL-BUP, sublingual formulation of buprenorphine and naloxone (Suboxone); VNPS verbal numerical pain score. Anesthetic agents and local anesthetics: Bupiv, bupivacaine; Clon, clonidine; Des, desflurane; Hydromor, hydromorphone; Iso, isoflurane; Mepiv, mepivacaine; N₂O, nitrous oxide; Pro, propofol; Pt, patient; Sevo, sevoflurane
^†Daily dose is shown as buprenorphine (naloxone) in milligrams; ^§Total IV-MEq includes intraoperative, PACU, and 24 h postoperative IV-MEq, ^¶Highest VNPS applies to 24 h after PACU discharge. *Ketorolac, multiple doses; ^‡Ketamine, multiple doses;
^a0 indicates that SL-BUP was preoperatively administered without interruption (ie, administered on the day of surgery or the night before); ^bPrimary anesthetic, ^cPain consultation requested, ^dPatient was preoperatively prescribed oxycodone, as needed (nonscheduled regimen); ^eCatheter inserted for continuous administration of local anesthesia, ^f“Single-shot” local anesthetic or opioid injection

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ISSN: 1471-2253

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