Buprenorphine for chronic pain treatment and elective orthopaedic surgery: a US national database analysis

Editor—Buprenorphine is a partial μ-opioid receptor agonist that is increasingly used for treatment of chronic pain.1,2 Buprenorphine has been reported to be associated with less respiratory depression and fewer adverse effects compared with full μ-opioid receptor agonists.2,3 Acute pain management of patients taking buprenorphine perioperatively can pose a challenge, and there is debate as to whether to continue buprenorphine in the perioperative period.4 The American Society of Regional Anesthesia and Pain Medicine recommends that patients prescribed buprenorphine for opioid use disorder be maintained on treatment during the perioperative period if possible, and be returned to their preoperative dose as soon as possible if treatment is interrupted.