Podcast # 492: Pain While on Buprenorphine
Emergency Medical Minute · medicalminute
July 26, 20194m 3s
Audio is streamed directly from the publisher (traffic.libsyn.com) as published in their RSS feed. Play Podcasts does not host this file. Rights-holders can request removal through the copyright & takedown page.
Show Notes
Contributor: Don Stader, MD
Educational Pearls:
- Buprenorphine is a partial Mu-agonist and binds with higher affinity than most opioids
- Pain management with opioids therefore can be difficult in patients taking buprenorphine
- Ketamine is a good option for pain control in these patients
- You can also consider using additional buprenorphine
- Intravenous buprenorphine is dosed differently than oral formulations
- Consider receptor availability - patients on high doses of buprenorphine (32mg) will have few Mu receptors available, and thus will likely not benefit from opiate pain meds of any kind
References
Alford DP, Compton P, Samet JH. Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Ann Intern Med. 2006;144(2):127–134.
Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD