Buprenorphine in acute pain: a partial agonist or not? (Letter)
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Vlok, R
Melhuish, T
Thang, C
White, L
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Abstract
Editor—There currently exists confusion regarding the status of buprenorphine as a partial agonist of the μ-opioid receptor (MOP), particularly in the setting of acute pain management for opioid-naïve patients.1 Buprenorphine, a semi-synthetic derivative of thebaine, has widely been used as both an analgesic and as a treatment for patients with opioid dependency.2 Originally, buprenorphine was classified as a partial agonist of MOP,3 however this has been met with doubt in the clinical context.4 Several studies have shown a lower rate of respiratory depression when compared with full MOP agonists.5 In addition to its safety profile, buprenorphine has several other advantages including sublingual administration.6, 7 Therefore, buprenorphine is regarded as an attractive agent for the management of acute pain. Given the renewed interest in buprenorphine, it is important to attempt to bring some clarity to the seemingly conflicting body of literature available.
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British Journal of Anaesthesia
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123
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4
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Clinical sciences
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Holyoak, R; Vlok, R; Melhuish, T; Thang, C; White, L, Buprenorphine in acute pain: a partial agonist or not?, British Journal of Anaesthesia, 2019, 123 (4), pp. e484