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

BMC Anesthesiology

Table 2 Procedural characteristics, and opioid requirements of patients who received long-term buprenorphine-naloxone (SL-BUP) therapy and surgical procedures with general anesthesia

Pt	SL-BUP Administration		Procedure Type (Anesthetic Agents) Year of Surgery	Surgical Time, min	Opioid Administration, IV-MEq				Highest VNPS^¶
Pt	Daily SL-BUP Dose, mg^†	Days Without SL-BUP^a	Procedure Type (Anesthetic Agents) Year of Surgery	Surgical Time, min	Intra- operative	PACU only	24 h after PACU Discharge	Total IV-MEq ^§	Highest VNPS^¶
1	1 (0.25)	0	Major orthopedic, (Des), 2011	322	78	27	318	423^*	9^b
2	2 (0.5)	0	Major oral (Des), 2012	206	61	26	115	202^*	9
3	8 (2)	0	Neurosurgery (Iso + N₂O), 2013	161	36	20	105	160	7^b
4	12 (3)	0	Neurosurgery (Iso), 2013	240	40	10	58	108	10
5	12 (3)	0	Minor dental (Des), 2013	47	18	32	55	105*	8^b
6	16 (4)	0	Neurosurgery (Des), 2013	130	28	15	38	80	10
7	16 (4)	0	Abdominal ^c (Iso), 2014	191	0	0	58	58^*/‡	8
8	16 (4)	0	Transplant (kidney) (Iso), 2010	251	69	5	55	129^*	8
9	32 (8)	0	Neurosurgery (Iso + N₂O), 2013	80	25	10	5	40	10
10	32 (8)	0	Neurosurgery (Des), 2013	122	15	0	0	15	5
11	8 (2)	1	Abdominal (Des), 2015	90	33	12	10	55	7
12	12 (3)	3	Major cardiac (Iso), 2013	338	179	ND	233	411^c	10^b
13	24 (6)	3	Gynecologic (Iso), 2009	332	60	18	33	110	10
14	8 (2)	4	Major cardiac (Iso), 2009	205	144	ND	111	254	10^b
15	24 (6)^d	5	Neurosurgery (Des), 2011	395	49	0	150	199	7^b
16	24 (6)	6	Major cardiac (Iso), 2015	163	241	ND	282	522^c	9^b
17	6 (1.5)^d	7	Neurosurgery (Iso + N₂O), 2009	39	25	30	58	113	9^b

Abbreviations: ICU intensive care unit; IV-MEq intravenous morphine equivalent; ND no data available because the patient was admitted to the intensive care unit after surgery; PACU, post-anesthesia care unit; Pt patient; SL-BUP sublingual formulation of buprenorphine and naloxone (Suboxone); VNPS verbal numerical pain score. Anesthetic agents: Des, desflurane; Iso, isoflurane; N₂O, nitrous oxide
^†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 dose; ^‡Ketamine, multiple dose
^a0 indicates that SL-BUP was preoperatively administered without interruption (ie, administered on the day of surgery or the night before); ^bPain consultation requested; ^cPatient preoperatively received 1000 mg acetaminophen 4 times daily, 800 mg ibuprofen 4 times daily, and lidocaine patch (5%) daily. This patient intraoperatively received 30 mg ketamine and 30 mg ketorolac (no opioids were administered); ^dPatient was preoperatively prescribed oxycodone, as needed (based on nonscheduled regimen)

ISSN: 1471-2253