Anesthesia Pain Management Strategies for Parturients on Medication Assisted Treatment-Anesthesia Pain Management Strategies Final Presentation

Anesthesia Pain Management Strategies Final Presentation

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This document discusses anesthesia pain management strategies for parturients (pregnant women) who are undergoing medication-assisted treatment (MAT) for opioid use disorder (OUD). The author starts by describing the three medications commonly used in MAT programs: methadone, buprenorphine, and naltrexone. They emphasize that discontinuation of MAT during pregnancy is not recommended as it poses a high risk of relapse.<br /><br />The author explains that MAT with methadone or buprenorphine is recommended for pregnant women with OUD to improve maternal and fetal outcomes. They also discuss the ceiling effect of buprenorphine, which means that increasing the dosage beyond a certain point does not increase its effects and reduces the risk of overdose and respiratory depression.<br /><br />The document provides information about the use of methadone in federally-licensed "methadone clinics" and recommends its use as a mono-product during pregnancy to minimize the impact of naloxone on the fetus. It also explains the receptor activity and pharmacokinetics of methadone.<br /><br />Non-opioid pain management strategies for pregnant women on MAT are discussed, including distraction, cognitive-behavioral therapy (CBT), stress-reducing mindfulness meditation, and hypnosis. The document also mentions alternative pain therapies such as trigger point/muscle injections, joint/bursa injections, and regional nerve blocks.<br /><br />The author concludes by emphasizing the importance of continuing MAT after delivery and avoiding discontinuation. They recommend contacting addiction treatment centers, splitting the medication dose if on buprenorphine or methadone, considering nerve blocks or epidural/spinal anesthesia, and using pre-emptive analgesia for surgery.<br /><br />Overall, this document provides information and strategies for managing anesthesia-related pain in pregnant women undergoing MAT for OUD, with a focus on the use of specific medications and non-opioid alternatives.

Keywords

anesthesia pain management

parturients

pregnant women

medication-assisted treatment

MAT

opioid use disorder

methadone

buprenorphine

non-opioid pain management

alternative pain therapies