PDF(Pubmed)
Abstract：
Although research suggests that less than half of individuals who have surgical procedures report effective postoperative pain alleviation, the majority of patients endure acute postoperative discomfort. To lessen and manage postoperative pain, a variety of preoperative, intraoperative, and postoperative treatments and management methods are available. For several years an opioid called buprenorphine has become an effective tool to treat opioid use disorder (OUD) in patients across many different demographics. It has however endured barriers to its usage which can be seen when treating patients with chronic pain or postoperative pain, who also have an OUD. While buprenorphine may be underutilized within the clinical setting, the significantly low rates of chronic abuse when using the drug allow it to be an attractive treatment option for patients. This paper aims to explore a wide range of studies that examine buprenorphine as an analgesic and how it can be used for preoperative pain and postoperative pain. This paper will give an in-depth analysis of buprenorphine and its use in patients with chronic pain as well as OUD. A systematic literature review was performed by identifying studies through the database PubMed. The data from various publications were gathered with preference being given to publications within the last three years. We reviewed studies that examined the pain level of the patients after having buprenorphine. Despite long-available pharmacologic evidence and clinical research, buprenorphine has maintained a mystique as an analgesic. Its usage in the treatment of OUD was further influenced by its well-known safety benefits and relative lack of psychomimetic side effects compared to other opioids. For patients accustomed to long-term, high-dose opioids who may be experiencing hyperalgesia but have not been informed about this phenomenon by their doctors or the potential for buprenorphine to resolve it, buprenorphine\'s pronounced antihyperalgesic effect is a compelling pharmacologic characteristic that makes it particularly attractive as an option. When used in pre-, peri-, and postoperative circumstances, buprenorphine provides various pain-management benefits and patients can still benefit from effective pain management from mu-opioid agonists while remaining on buprenorphine. Buprenorphine can be continued at a reduced dose as needed to avoid withdrawal symptoms and to improve the analgesic efficiency of mu-opioid agonists used in combination with acute postoperative pain in light of the evidence at hand. Buprenorphine administration needs a patient-centered, multidisciplinary strategy that considers the benefits and drawbacks of the many perioperative therapy options to have the best chance of success.
摘要：
尽管研究表明，只有不到一半的手术患者报告术后疼痛得到有效缓解，大多数患者忍受急性术后不适。为了减轻和控制术后疼痛，各种术前，术中,术后治疗和管理方法可用。几年来，一种名为丁丙诺啡的阿片类药物已成为治疗许多不同人口统计学患者阿片类药物使用障碍（OUD）的有效工具。然而，它在治疗慢性疼痛或术后疼痛的患者时可以看到它的使用障碍，他们也有一个OUD。虽然丁丙诺啡在临床环境中可能未得到充分利用，使用该药物时慢性滥用率明显较低，因此对患者来说是一种有吸引力的治疗选择。本文旨在探索广泛的研究，以检查丁丙诺啡作为镇痛药以及如何将其用于术前疼痛和术后疼痛。本文将对丁丙诺啡及其在慢性疼痛和OUD患者中的应用进行深入分析。通过数据库PubMed识别研究进行了系统的文献综述。收集了来自各种出版物的数据，并优先考虑了过去三年内的出版物。我们回顾了研究丁丙诺啡后患者疼痛程度的研究。尽管有长期的药理学证据和临床研究，丁丙诺啡作为镇痛药一直保持神秘感。与其他阿片类药物相比，其在OUD治疗中的使用进一步受到其众所周知的安全益处和相对缺乏精神模拟副作用的影响。对于长期习惯的患者，高剂量阿片类药物可能正在经历痛觉过敏，但没有被医生告知这种现象或丁丙诺啡解决它的潜力，丁丙诺啡明显的抗痛觉过敏作用是一个引人注目的药理学特征，使其作为一种选择特别有吸引力。当在预使用时，pery-,和术后情况，丁丙诺啡提供各种疼痛管理益处,患者仍可从mu-阿片激动剂的有效疼痛管理中获益,同时仍继续服用丁丙诺啡.丁丙诺啡可以根据需要以减少的剂量继续使用，以避免戒断症状并根据现有证据提高与急性术后疼痛联合使用的mu-阿片激动剂的镇痛效率。丁丙诺啡给药需要以患者为中心,多学科策略，考虑了许多围手术期治疗方案的利弊，以获得最大的成功机会。
