Date of this Version


Document Type

DNP Project




Background: Buprenorphine is a semisynthetic opioid agonist-antagonist that displays antagonism at kappa receptors and partial agonist at mu receptors. Buprenorphine has the unfortunate effect of interfering with the actions of opioids administered for medical indications. When patients on buprenorphine present for surgery or procedures requiring anesthesia, it can become a substantial challenge. Currently, there are no guidelines or checklists that would help the anesthetist to provide adequate pain management for the OUD patient population.

Objectives: (1) Understand the perioperative management of patients with opioid addiction on buprenorphine. (2) Demonstrate increased knowledge and confidence in understanding the challenges, pharmacokinetics, and pharmacodynamics of managing a patient on buprenorphine. (3) Discuss and manage perioperative interventions of patients taking buprenorphine with opioid addiction.

Methodology: The primary methodology of the proposed project was to administer an online Zoom educational module to providers that focus on the perioperative management of patients with OUD who take buprenorphine. The project was implemented by conducting an online pre-assessment test, zoom educational module, and a post-assessment test that assessed the anesthesia providers' knowledge about managing a patient with OUD on buprenorphine during the perioperative period. Pre-assessment and post-assessment testing were used to measure the effects of the educational module. Statistical analysis was applied to assess the effectiveness of the educational module.

Results: There was a total of five Certified Registered Nurse Anesthetists (CRNAs) that participated in the quality improvement project. The results reflected an improvement in knowledge based on the pre-test and post-test scores. Knowledge showed an average gain of (25%). In addition, the post-test demonstrated that participants are most likely (n=4, 80%) or somewhat likely (n=2, 20%) to implement a perioperative checklist for surgical patients with opioid addiction taking buprenorphine.

Conclusion: An evidence-based educational module determined an increase in participants' knowledge of managing surgical patients with OUD taking buprenorphine during the perioperative period. There is no consensus on the management of buprenorphine; however, the recommendation is to continue buprenorphine during the perioperative period.