Low-Dose Buprenorphine Initiation in Acute Burn Setting, a Retrospective Chart Review.

IF 1.8 4区 医学 Q3 CRITICAL CARE MEDICINE
Mladen Nisavic, Matthew Supple, Daniela Requena, Ashika Bains, Jeremy Goverman
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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.

急性烧伤起始低剂量丁丙诺啡,回顾性图表回顾。
阿片类药物使用障碍(OUD)是造成非故意烧伤的重要原因。OUD患者的疼痛管理需要复杂的多模式治疗,对患者及其临床团队提出了重大挑战。丁丙诺啡已被公认为阿片类药物使用障碍医学治疗的标准护理,然而,在伴有明显合并症疼痛的手术患者中使用丁丙诺啡被认为有急性疼痛控制恶化和/或沉淀戒断的风险。由于丁丙诺啡治疗具有相当大的益处,因此已经开发了替代方法来促进丁丙诺啡在急性围手术期的引入。我们提出了一项首次回顾性队列综述,研究了低剂量丁丙诺啡在急性烧伤情况下的使用。我们的大多数患者(86%)能够开始使用丁丙诺啡,而不会对疼痛产生不良影响,也不会出现急性戒断。所有这些患者都能够过渡到门诊OUD护理丁丙诺啡处方。顺便说一句,我们还注意到丁丙诺啡的开始也与出院时阿片类药物处方的减少有关,只有50%的患者在丁丙诺啡的基础上需要短暂的短效逐渐减少。进一步的研究应该解决患者群体的长期结果,以及如何最好地全面管理物质使用障碍和并发烧伤的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
535
审稿时长
4-8 weeks
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.
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