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Peri-operative pain in patient taking buprenorphine — FRCA Final MCQ

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ModeratePerioperative MedicinePeri-operative pain in patient taking buprenorphineFRCA Final

A 58-year-old man taking buprenorphine 16 mg daily for opioid dependence is scheduled for open abdominal wall reconstruction. He is anxious that postoperative pain will be undertreated, has normal liver and renal function, and has been stable in recovery for three years. What is the most appropriate pain management?

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Correct answer: C — Continue buprenorphine and use a planned multimodal analgesic strategy

Peri-operative pain in patients taking buprenorphine should be planned in advance, usually continuing baseline therapy and adding multimodal analgesia with regional techniques where appropriate. Abrupt cessation risks withdrawal, relapse and difficult analgesia. Stigmatising undertreatment is unsafe and unethical. Complex cases benefit from acute pain and addiction-team input.

Reference: Faculty of Pain Medicine Surgery and Opioids guidance; BNF