TY - JOUR
KW - Adult
KW - Analgesics, Opioid/administration & dosage/adverse effects/pharmacology
KW - Buprenorphine/administration & dosage/adverse effects/pharmacology
KW - Cesarean Section/adverse effects
KW - Female
KW - Humans
KW - Length of Stay/statistics & numerical data
KW - Methadone/administration & dosage/adverse effects/pharmacology
KW - Opioid-Related Disorders/drug therapy
KW - Outcome Assessment (Health Care)
KW - Pain Management
KW - Pain, Postoperative/drug therapy
KW - Retrospective Studies
KW - Safety-net Providers/statistics & numerical data
KW - Urban Population/statistics & numerical data
KW - Young Adult
AU - Annmarie L. Vilkins
AU - Sarah M. Bagley
AU - Kristen A. Hahn
AU - Florencia Rojas-Miguez
AU - Elisha M. Wachman
AU - Kelley Saia
AU - Daniel P. Alford
A1 - 
AB - OBJECTIVE: Buprenorphine is a highly effective treatment for opioid use disorders, but its continuation in the perioperative setting remains controversial, unlike the accepted practice of perioperative methadone continuation. METHODS: We conducted a retrospective cohort study from 2006 to 2014 comparing post-cesarean section opioid analgesic requirements of women with opioid use disorders treated with methadone or buprenorphine. Preoperative, intraoperative, and postoperative opioid requirements (morphine equivalent dose [MED]), postoperative complications, and length of stay were compared between the methadone and buprenorphine groups. RESULTS: During the 9-year study period, there were 185 women treated with methadone (mean dose 93.7 mg, SD 2.6) and 88 women treated with buprenorphine (mean dose 16.1 mg, SD 7.8). There were no statistically significant differences in MED requirements in the methadone versus buprenorphine groups: preoperative MED (11.4 mg [SD 31.5] vs 20.0 mg [SD 15.1]; mean difference [MD] 8.6, 95% confidence interval [CI] -1.9, 19.1), intraoperative MED (3.5 mg [SD 6.6] vs 5.2 mg [SD 13.7]; MD 1.8, 95% CI -1.1, 4.6), and postoperative MED during hospitalization (97.7 mg [SD 65.6] vs 85.1 mg [SD 73.0]; MD -12.6, 95% CI -31.1, 5.8). There were no statistically significant differences in postoperative complications or length of stay. CONCLUSIONS: Our study suggests that buprenorphine treatment will not interfere more than methadone with pain management after a cesarean section with no significant differences in opioid analgesic requirements, postoperative complications, or length of hospital stay. Future studies should investigate the generalizability to other surgeries.
AD - Boston Medical Center, Boston, MA (ALV, SMB, EMW, KS, DPA); Boston University School of Medicine, Boston, MA (SMB, FR-M, EMW, KS, DPA); Boston University School of Public Health, Boston, MA (KAH); and QuintilesIMS, Cambridge, MA (KAH).
BT - Journal of addiction medicine
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 5
CY - United States
DO - 10.1097/ADM.0000000000000339
IS - 5
JF - Journal of addiction medicine
LA - eng
M1 - Journal Article
N2 - OBJECTIVE: Buprenorphine is a highly effective treatment for opioid use disorders, but its continuation in the perioperative setting remains controversial, unlike the accepted practice of perioperative methadone continuation. METHODS: We conducted a retrospective cohort study from 2006 to 2014 comparing post-cesarean section opioid analgesic requirements of women with opioid use disorders treated with methadone or buprenorphine. Preoperative, intraoperative, and postoperative opioid requirements (morphine equivalent dose [MED]), postoperative complications, and length of stay were compared between the methadone and buprenorphine groups. RESULTS: During the 9-year study period, there were 185 women treated with methadone (mean dose 93.7 mg, SD 2.6) and 88 women treated with buprenorphine (mean dose 16.1 mg, SD 7.8). There were no statistically significant differences in MED requirements in the methadone versus buprenorphine groups: preoperative MED (11.4 mg [SD 31.5] vs 20.0 mg [SD 15.1]; mean difference [MD] 8.6, 95% confidence interval [CI] -1.9, 19.1), intraoperative MED (3.5 mg [SD 6.6] vs 5.2 mg [SD 13.7]; MD 1.8, 95% CI -1.1, 4.6), and postoperative MED during hospitalization (97.7 mg [SD 65.6] vs 85.1 mg [SD 73.0]; MD -12.6, 95% CI -31.1, 5.8). There were no statistically significant differences in postoperative complications or length of stay. CONCLUSIONS: Our study suggests that buprenorphine treatment will not interfere more than methadone with pain management after a cesarean section with no significant differences in opioid analgesic requirements, postoperative complications, or length of hospital stay. Future studies should investigate the generalizability to other surgeries.
PP - United States
PY - 2017
SN - 1935-3227; 1932-0620
SP - 397
EP - 401
EP - 
T1 - Comparison of Post-Cesarean Section Opioid Analgesic Requirements in Women With Opioid Use Disorder Treated With Methadone or Buprenorphine
T2 - Journal of addiction medicine
TI - Comparison of Post-Cesarean Section Opioid Analgesic Requirements in Women With Opioid Use Disorder Treated With Methadone or Buprenorphine
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 28727661
U3 - 10.1097/ADM.0000000000000339
VL - 11
VO - 1935-3227; 1932-0620
Y1 - 2017
Y2 - Sep/Oct
ER -