Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine
Abstract Background We tested the hypothesis that patients who continued buprenorphine postoperatively experience postoperative respiratory depression less frequently than those who discontinued buprenorphine. Methods This is a retrospective cohort study of patients who were on buprenorphine preoper...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-06-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-022-00535-2 |
| _version_ | 1811235614216945664 |
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| author | Ryu Komatsu Michael D. Singleton Katherin A. Peperzak Jiang Wu Emily M. Dinges Laurent A. Bollag |
| author_facet | Ryu Komatsu Michael D. Singleton Katherin A. Peperzak Jiang Wu Emily M. Dinges Laurent A. Bollag |
| author_sort | Ryu Komatsu |
| collection | DOAJ |
| description | Abstract Background We tested the hypothesis that patients who continued buprenorphine postoperatively experience postoperative respiratory depression less frequently than those who discontinued buprenorphine. Methods This is a retrospective cohort study of patients who were on buprenorphine preoperatively. The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/minute, oxygen saturation (SpO2) < 90%, or requirement of naloxone for 48 h postoperatively. The secondary outcome was the composite of postoperative respiratory complications. The associations between postoperative buprenorphine continuation and respiratory depression and respiratory complications were estimated using separate multivariable logistic regression models, including demographic, intraoperative characteristics, and preoperative buprenorphine dose as covariates. Results Postoperative buprenorphine continuation was not associated with postoperative respiratory depression (adjusted odds ratio (OR), 1.11, 95% confidence interval (CI), 0.61 to 1.99, P=0.72). In subanalysis stratified by the preoperative buprenorphine dose, buprenorphine continuation was not associated with postoperative respiratory depression either when preoperative buprenorphine dose was high (≥16 mg daily) or low (<16 mg daily). Postoperative buprenorphine continuation was associated with lower incidence of postoperative respiratory complications (adjusted OR, 0.43, 95% CI, 0.21 to 0.86, P=0.02). Conclusions Continuing buprenorphine was not associated with respiratory depression, but it was associated with a lower incidence of respiratory complications. |
| first_indexed | 2024-04-12T11:54:54Z |
| format | Article |
| id | doaj.art-815f80815ac7446eac9110840f78a8cd |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-04-12T11:54:54Z |
| publishDate | 2022-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-815f80815ac7446eac9110840f78a8cd2022-12-22T03:34:02ZengSpringerOpenJA Clinical Reports2363-90242022-06-01811910.1186/s40981-022-00535-2Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphineRyu Komatsu0Michael D. Singleton1Katherin A. Peperzak2Jiang Wu3Emily M. Dinges4Laurent A. Bollag5Department of Anesthesiology and Pain Medicine, University of WashingtonInstitute of Translational Health Sciences, University of WashingtonDepartment of Anesthesiology and Pain Medicine, University of WashingtonDepartment of Anesthesiology and Pain Medicine, University of WashingtonDepartment of Anesthesiology and Pain Medicine, University of WashingtonDepartment of Anesthesiology and Pain Medicine, University of WashingtonAbstract Background We tested the hypothesis that patients who continued buprenorphine postoperatively experience postoperative respiratory depression less frequently than those who discontinued buprenorphine. Methods This is a retrospective cohort study of patients who were on buprenorphine preoperatively. The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/minute, oxygen saturation (SpO2) < 90%, or requirement of naloxone for 48 h postoperatively. The secondary outcome was the composite of postoperative respiratory complications. The associations between postoperative buprenorphine continuation and respiratory depression and respiratory complications were estimated using separate multivariable logistic regression models, including demographic, intraoperative characteristics, and preoperative buprenorphine dose as covariates. Results Postoperative buprenorphine continuation was not associated with postoperative respiratory depression (adjusted odds ratio (OR), 1.11, 95% confidence interval (CI), 0.61 to 1.99, P=0.72). In subanalysis stratified by the preoperative buprenorphine dose, buprenorphine continuation was not associated with postoperative respiratory depression either when preoperative buprenorphine dose was high (≥16 mg daily) or low (<16 mg daily). Postoperative buprenorphine continuation was associated with lower incidence of postoperative respiratory complications (adjusted OR, 0.43, 95% CI, 0.21 to 0.86, P=0.02). Conclusions Continuing buprenorphine was not associated with respiratory depression, but it was associated with a lower incidence of respiratory complications.https://doi.org/10.1186/s40981-022-00535-2BuprenorphineOpioid use disorderRespiratory depressionRespiratory complications |
| spellingShingle | Ryu Komatsu Michael D. Singleton Katherin A. Peperzak Jiang Wu Emily M. Dinges Laurent A. Bollag Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine JA Clinical Reports Buprenorphine Opioid use disorder Respiratory depression Respiratory complications |
| title | Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| title_full | Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| title_fullStr | Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| title_full_unstemmed | Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| title_short | Postoperative respiratory depression in patients on sublingual buprenorphine: a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| title_sort | postoperative respiratory depression in patients on sublingual buprenorphine a retrospective cohort study for comparison between postoperative continuation and discontinuation of buprenorphine |
| topic | Buprenorphine Opioid use disorder Respiratory depression Respiratory complications |
| url | https://doi.org/10.1186/s40981-022-00535-2 |
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