Perioperative Considerations for the Patient with Opioid Use Disorder on Buprenorphine, Methadone, or Naltrexone Maintenance Therapy

Anesthesiol Clin. 2018 Sep;36(3):345-359. doi: 10.1016/j.anclin.2018.04.002. Epub 2018 Jul 11.


As part of a national effort to combat the current US opioid epidemic, use of currently Food and Drug Administration-approved drugs for the treatment of opioid use disorder/opioid addiction (buprenorphine, methadone, and naltrexone) is on the rise. To provide optimal pain control and minimize the risk of relapse and overdose, providers need to have an in-depth understanding of how to manage these medications in the perioperative setting. This article reviews key principles and discusses perioperative considerations for patients with opioid use disorder on buprenorphine, methadone, or naltrexone.

Keywords: Addiction; Buprenorphine; Methadone; Multi modal pain management; Naltrexone; Opioid use disorder; Perioperative; Relapse.

Publication types

  • Review

MeSH terms

  • Buprenorphine / pharmacology
  • Buprenorphine / therapeutic use*
  • Humans
  • Methadone / pharmacology
  • Methadone / therapeutic use*
  • Naltrexone / pharmacology
  • Naltrexone / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Pain Management
  • Perioperative Care*


  • Buprenorphine
  • Naltrexone
  • Methadone