The Effect of Buprenorphine Continuation for Patients With Opioid Use Disorder

• Status: Not yet recruiting
• Trial end date: 2023-01-31
• Target enrollment: 0
• Participant gender: All

Summary

There is limited guidance on the optimal management of buprenorphine perioperatively and both buprenorphine discontinuation and continuation are acceptable standards of care. However, there is the risk for opioid cravings and relapse when buprenorphine is discontinued. Conversely, there is the risk of inadequate pain control necessitating opioid escalation in when buprenorphine is continued. Preliminary clinical observations support buprenorphine continuation at low analgesic doses (8mg) can adequately facilitate postoperative pain management without interrupting opioid use disorder (OUD) treatment, however to date, no prospective trial has investigated this treatment strategy in comparison to buprenorphine discontinuation. Since optimal perioperative dosing strategies remain unknown, the purpose of this study is to investigate if buprenorphine continuation at analgesic dosing is superior to buprenorphine discontinuation in individuals presenting for elective surgery.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Aurora Quaye
• Collaborator: MaineHealth
• Treatments: Buprenorphine

Criteria

Inclusion Criteria:

• age 18 and older

• American Society of Anesthesia health class I-III

• Currently taking buprenorphine formulation equivalent to 8mg or greater for at least 30 days for treatment of Opioid Use Disorder

• Scheduled for surgery at Maine Medical Center for a procedure with a greater than 4/10 pain intensity is expected on post-op day one.

Exclusion Criteria:

• unable to consent to the study

• currently pregnant

• current major medical illness that could limit the ability to utilize medications within our protocol driven multimodal analgesic plan (e.g. cancer, severe end-stage organ disease, or dementia)