Document Detail

Buprenorphine maintenance therapy hinders acute pain management in trauma.
MedLine Citation:
PMID:  20420250     Owner:  NLM     Status:  MEDLINE    
Buprenorphine is a mixed opiate receptor agonist-antagonist growing in popularity as an office-based treatment for opioid-dependent patients. It has high affinity, but only partial agonism at the micro-opioid receptor resulting in a ceiling analgesic effect. At higher doses, buprenorphine potentiates antagonism at the kappa-opioid receptor. These properties make buprenorphine an effective maintenance treatment for opioid-dependent patients. These same properties, however, can interfere with the management of acute pain in patients on maintenance buprenorphine therapy. We present a case of a young multisystem trauma patient in whom adequate analgesia could not be achieved due to buprenorphine treatment before and through the early course of admission. Discontinuation of buprenorphine allowed for appropriate pain management and successful analgesia. Further education of acute care clinicians about buprenorphine pharmacology and careful selection of patients for buprenorphine maintenance therapy are needed to avoid delays of pain control in trauma patients.
Colin J Harrington; Victor Zaydfudim
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American surgeon     Volume:  76     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  397-9     Citation Subset:  IM    
Department of Psychiatry, Brown Medical School and Rhode Island Hospital, Providence, Rhode Island 02903, USA.
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MeSH Terms
Accidents, Traffic
Analgesics, Opioid / administration & dosage,  adverse effects*
Buprenorphine / administration & dosage,  adverse effects*
Drug Interactions
Narcotic Antagonists / administration & dosage,  adverse effects*
Opioid-Related Disorders / complications
Pain / drug therapy*
Grant Support
T32 HS 013833/HS/AHRQ HHS
Reg. No./Substance:
0/Analgesics, Opioid; 0/Narcotic Antagonists; 52485-79-7/Buprenorphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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