Continuation versus Interruption of Buprenorphine/Naloxone in Adult Veterans Undergoing Surgery: Examination of Postoperative Pain and Opioid Utilization in a National Retrospective Cohort Study
Authors' conclusion
Continuation of buprenorphine is not associated with higher average pain scores or postoperative opioid requirements
Study context
- Population
- Veterans undergoing surgery while prescribed buprenorphine/naloxone for opioid use disorder, Veterans Affairs Corporate Data Warehouse, 2010–20201,881 procedures in buprenorphine users
- Participants
- 1,186 / 695 / 5,748
- Exposure
- Continued buprenorphine vs Interrupted buprenorphine vs Control
- Continued buprenorphinen = 1,186
- Interrupted buprenorphinen = 695
- Controln = 5,748reference
- Outcome
- Time-weighted average postoperative pain scores (inpatient and outpatient sources)
- Follow-up
- Within 72 h of surgery
Methodological detailsnational, 3:1 matched controls
- National
- 3:1 matched controls
Main finding
As reported in the abstract
Control
4.1
SD 1.9 · n = 3,284
Continued buprenorphine
4.9
SD 2.0 · n = 662
Interrupted buprenorphine
5.5
SD 1.7 · n = 419
P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Postoperative average daily supplemental opioid requirement (morphine equivalents) · within 2 weeks of surgery — Continued buprenorphine vs Control · not significantly more
P = 0.23
| Outcome | P value |
|---|---|
| Postoperative average daily supplemental opioid requirement (morphine equivalents) · within 2 weeks of surgeryInterrupted buprenorphine vs Continued buprenorphine · more supplemental opioids with interruption | P < 0.001 |
Original publication
Continuation versus Interruption of Buprenorphine/Naloxone in Adult Veterans Undergoing Surgery: Examination of Postoperative Pain and Opioid Utilization in a National Retrospective Cohort Study. Anesthesiology. Published 11 November 2024. doi:10.
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