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首页> 外文期刊>The journal of clinical psychiatry >Perioperative Buprenorphine Continuous Maintenance and Administration Simultaneous With Full Opioid Agonist: Patient Priority at the Interface Between Medical Disciplines
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Perioperative Buprenorphine Continuous Maintenance and Administration Simultaneous With Full Opioid Agonist: Patient Priority at the Interface Between Medical Disciplines

机译：围手术期丁丙诺啡连续维护和给药同时用全阿片类毒剂：患者优先于医学学科之间的界面

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Buprenorphine is a partial-agonist opioid that is prescribed as a medication-assisted treatment (MAT) for opioid use disorder (OUD). Buprenorphine is also a potent analgesic with high opioid-receptor affinity and binding coefficient; when buprenorphine is administered simultaneously with mu-opioid receptor full agonist ("full agonist opioid" [FAQ]), the combination can yield unexpected outcomes depending on dosing and timing. Buprenorphine is sometimes perceived as a powerful competitive opioid blocker that will hamper pharmacologic management that necessitates the use of FAO. When patients receiving buprenorphine-MAT (BUP-MAT) formulations have presented for operative procedures, there has been clinical variance in approach to their BUP-MAT management. Recognizing the risk management challenge from both analgesia and BUP-MAT perspectives, we convened a multidisciplinary group of clinicians who treat BUP-MAT patients and completed a literature review with the goal of generating a guideline for appropriate management of these patients presenting for a broad spectrum of surgical procedures. Our conclusion is that continuous simultaneous administration of buprenorphine products with FAO is safe when accounting for dose and timing, including surgeries that historically produce moderate to severe pain, and may further provide an analgesic advantage, lessen FAO burden, and reduce relapse risk to this group.
机译：丁丙诺啡是一种部分激动剂阿片类药物，用于治疗阿片类药物使用障碍（OUD）。丁丙诺啡也是一种具有高阿片受体亲和力和结合系数的强效镇痛剂；当丁丙诺啡与mu阿片受体全激动剂（“全激动剂阿片”[FAQ]）同时给药时，根据剂量和时间，联合用药可能会产生意想不到的结果。丁丙诺啡有时被认为是一种强大的竞争性阿片受体阻滞剂，会阻碍药理学管理，这就需要使用FAO。当接受丁丙诺啡MAT（BUP-MAT）制剂的患者提出手术治疗时，他们的BUP-MAT治疗方法存在临床差异。从镇痛和BUP-MAT的角度认识到风险管理的挑战，我们召集了一个多学科的临床医生小组来治疗BUP-MAT患者，并完成了一项文献综述，目的是为这些患者的广泛外科手术制定适当管理指南。我们的结论是，考虑到剂量和时间，包括历史上产生中度至重度疼痛的手术，与FAO同时持续服用丁丙诺啡产品是安全的，并且可能进一步提供镇痛优势，减轻FAO负担，并降低该人群的复发风险。

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