Mladen Nisavic, Matthew Supple, Daniela Requena, Ashika Bains, Jeremy Goverman
{"title":"Low-Dose Buprenorphine Initiation in Acute Burn Setting, a Retrospective Chart Review.","authors":"Mladen Nisavic, Matthew Supple, Daniela Requena, Ashika Bains, Jeremy Goverman","doi":"10.1093/jbcr/iraf163","DOIUrl":null,"url":null,"abstract":"<p><p>Opioid use disorder (OUD) is a significant cause of unintentional burn injuries. Pain management in OUD patients requires complex multi-modal treatment and places significant challenges on the patient and their clinical team. Buprenorphine has been well-established as a standard of care in the medical treatment of opioid use disorder, however, its use in surgical patients with significant co-morbid pain was felt to carry a risk for both worsened acute pain control and/or precipitation of withdrawal. As treatment with buprenorphine carries considerable benefits, alternative approaches have been developed to facilitate buprenorphine introduction in the acute peri-operative setting. We present a first-ever retrospective cohort review examining the use of low-dose buprenorphine acute burn injury setting. The majority of our patient cohort (86%) was able to initiate buprenorphine without adverse impact on pain, or emergence of precipitated withdrawal. All of these patients were able to transition to outpatient OUD care for buprenorphine prescribing. Incidentally, we also note that buprenorphine initiation was also associated with reduced opioid prescribing at discharge, with only 50% of our patient cohort requiring a brief short-acting taper in addition to buprenorphine. Further studies should address long-term outcomes in the patient population as well as how to best holistically manage patients with substance use disorder and concurrent burn injuries.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Burn Care & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jbcr/iraf163","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Opioid use disorder (OUD) is a significant cause of unintentional burn injuries. Pain management in OUD patients requires complex multi-modal treatment and places significant challenges on the patient and their clinical team. Buprenorphine has been well-established as a standard of care in the medical treatment of opioid use disorder, however, its use in surgical patients with significant co-morbid pain was felt to carry a risk for both worsened acute pain control and/or precipitation of withdrawal. As treatment with buprenorphine carries considerable benefits, alternative approaches have been developed to facilitate buprenorphine introduction in the acute peri-operative setting. We present a first-ever retrospective cohort review examining the use of low-dose buprenorphine acute burn injury setting. The majority of our patient cohort (86%) was able to initiate buprenorphine without adverse impact on pain, or emergence of precipitated withdrawal. All of these patients were able to transition to outpatient OUD care for buprenorphine prescribing. Incidentally, we also note that buprenorphine initiation was also associated with reduced opioid prescribing at discharge, with only 50% of our patient cohort requiring a brief short-acting taper in addition to buprenorphine. Further studies should address long-term outcomes in the patient population as well as how to best holistically manage patients with substance use disorder and concurrent burn injuries.
期刊介绍:
Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.