AANA June 2022 Journal Course: Demystifying Buprenorphine with Current Evidence-Based Practice in Acute and Chronic Pain Management-Article

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This article discusses the use of buprenorphine in the management of acute and chronic pain. Buprenorphine's unique pharmacological profile and safety profile make it a desirable analgesic option. The article highlights the receptor pharmacology and pharmacokinetics of buprenorphine, clarifying misconceptions about its efficacy and classification as a partial opioid receptor agonist. The article emphasizes that buprenorphine is a potent analgesic and does not have an analgesic ceiling effect. It also discusses the differences between buprenorphine and Suboxone, a combination of buprenorphine and naloxone, and provides guidelines for the management of surgical patients on buprenorphine. The article also mentions the immunomodulatory effects of opioid therapy, with buprenorphine showing no negative impact on immune function. <br /><br />The article highlights the efficacy of buprenorphine in both acute and chronic pain management. It mentions that buprenorphine has been found to be effective in treating immediate postoperative pain and that it provides comparable or better analgesia compared to morphine. The article also discusses the use of buprenorphine in chronic pain management, noting its favorable therapeutic index and slower onset of tolerance compared to other opioids. Various formulations of buprenorphine, including transdermal and buccal, are discussed in the context of chronic pain management.<br /><br />The article concludes by addressing the perioperative management of patients on buprenorphine or Suboxone, recommending the continuation of buprenorphine in the perioperative period to provide better pain control and avoid withdrawal. It also mentions the importance of a multi-modal approach to pain management for these patients. The article highlights the safety and tolerability of buprenorphine and emphasizes the need for healthcare providers to understand its unique pharmacological properties in order to provide effective pain management for patients.

Keywords

buprenorphine

acute pain management

chronic pain management

pharmacology

pharmacokinetics

analgesic

Suboxone

surgical patients

immunomodulatory effects

perioperative management