QuestionsCategory: Opioid Dosingwill-buprenorphine-subutex-affect-general-anesthesia-meds
Brooke asked 4 years ago

I am interested in having rhinoplasty soon to improve the functionality & aesthetics of my nose. I\’m currently prescribed buprenorphine (subutex) 6-8mg/daily. My question is will this affect me being put under? The surgeon will be using 50-100mcg Fentanyl. Will they have to use more on me? I\’ve been researching this but most the are in regards to postoperative pain management. The surgeon said that pain the next day is minimal, like a head cold & headache. They prescribe steroids (for swelling) & ibuprofen. If it will affect my sedation, should I taper down or stop my meds prior to surgery?

1 Answers
Jeffrey Fudin Staff answered 4 years ago

Brooke,  Generally speaking IV fentanyl should work fine when you are on buprenorphine.  I agree with your surgeon that steroids and NSAIDs work best for this sort of pain after surgery.  One suggestion you may want to make to your surgeon however is that I prefer to use NSAIDs with lower risk of bleed so that there is less bleeding and leakage after surgery.  My preference is usually etodolac, although most surgeons use ibuprofen or naproxen out of habit, and they all work.