Sublingual Buprenorphine

by Dr. Rich on September 5, 2011

OPIOID-DEPENDENT PATIENTS present a unique perioperative care challenge. These patients are managed as outpatients in several different manners. The type of treatment that such patients receive can have a profound impact on their perioperative care when they present for surgery. One management option is the use of sublingual (SL) buprenorphine to treat opioid dependence. This drug is available as either Suboxone or Subutex (Reckitt Benckiser Pharmaceuticals, Inc, Richmond, VA). Subutex contains buprenorphine only, whereas Suboxone contains buprenorphine and naloxone to deter diversion to the injectable route (naloxone will precipitate opioid withdrawal if injected, but has no effect if taken sublingually or orally). As we shall see, the same properties that make buprenorphine effective in…

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