TITLE:
Life after Addiction—Post-Operative Pain Management in an Obstetrical Patient on Long-Term Buprenorphine Therapy
AUTHORS:
Kelly R Bowen, Jonathan D Baum
KEYWORDS:
Buprenorphine, Methadone, Addiction, Pregnancy, Opiate Use in Pregnancy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.9,
September
15,
2017
ABSTRACT: A G6P2032 female, prior cesarean x3 with history of opioid addiction maintained
on buprenorphine presented for scheduled repeat cesarean section.
Pre-operatively, her maintenance dose of medication was held secondary to
concerns for partial agonist effect. Post-operative pain control was suboptimal
with the patient ultimately proceeding to withdrawal. Doses of hydromorphone
were titrated to 10 mg every 3 hours to avoid further withdrawal. Review of expert opinion
after discharge recommended against holding buprenorphine therapy in the
post-operative period. Pain management options include maintenance therapy with
additional doses of opioid and non-opioid pain relieving medications.