Acute Pain Management in Patients on Buprenorphine Continue Maintenance Buprenorphine (Divide dose q4-8hrs) Non-opioid analgesia: - Promote calm and comfort - Regional Anesthesia - Acetaminophen and NSAIDs - Gabapentinoids - Alpha-2 Agonists - Ketamine & Magnesium - IV Lidocaine Additional opioids: - Option 1 - High affinity full agonist opioids: Fentanyl, Hydromorphone - Option 2 - Additional Bup: Increase SL Bup / Start IV Bup Taper down to maintenance dose Bup #Buprenorphine #Pain #Management #addiction