Aa
subutex and general anesthesia
I am having my tonsils taken out on march 1st and have been taking subutex 16 mg/day for 10 months. I am an operating room nurse and have talked to a couple of anesthesia doctors and none of them no about this medication. I am also trying to get preg and my obgyn said its a good drug to be on when you have a baby for pain control, she said not to change any dose. Does anyone know anything about either of my situations.
The reason I am on subutex is because I became addicted to narcotics...I started out will a mild back pain and my pcp gave me 5/500 percocets x180 for a month, he is know to over do it. then it turned into 10/325 percocet x180 month with vicodin then ativan 3 mg to bring myself down from my high each day annd 10 mg of zoloft to go to sleep. I did this for about 1 1/2 years and found out about suboxone. I started it and it made me feel horrible so I went back to pills. Then when I tried to stop again they tried subutex and I have felt great. As I said I am a nurse and am very educated about all of these medications and felt like a failure to be addicted. Its usually only a story you hear about and not experience. I will definitely start tapering off subutex before I get pregnant. May I ask, how do you know so much about subutex? What kind of medical professional are you. Thank you for taking the time to help me and give me information.
MEDICAL PROFESSIONAL
I see several components to your questions. First, you need to understand yourself what Subutex is. I am not sure why you are on it, but here is a relatively simple explanation, since you are a medical professional, I think you should have no problem.
Subutex is the brand name of buprenorphine. Buprenorphine is a thebaine derivative with powerful analgesia approximately 20-40x more potent than morphine. Buprenorphine is a partial agonist and antagonist of the opioid receptors in the central nervous system which means that when its molecule binds to a receptor, it will transduce only a partial response in contrast to a full agonist such as morphine. Buprenorphine also has very high binding to the opioid receptors such that the opioid receptor antagonists (e.g. naloxone) only partially reverse its effects. This means that an overdose of buprenorphine cannot be easily reversed. In the US Subutex has been approved by the FDA for the treatment and control of chronic moderate to severe pain.
If you are using it for treatment of addiction, it was not supposed to be a maintenance medication. The goal of it was to taper that addict relatively quickly, over several months, off of the medication completely.
By reading the above, you may have already understood, that pain control may be an issue during your tonsillectomy. Since buprenorphine has such high affinity to the opioid receptor it will essentially displace, or knock off most other opiates they will try to use during the surgery. Since you already are on a very high dose of buprenorphine your requirement for opiates will be high and most of what they will give will not be sufficient. You might just have to deal with the pain by eating ice cream.
Other anesthetics like gas. propofol and muscle relaxants should not be affected and can be used as usual. So you will sleep through surgery just fine. It is the post operative pain that will be a problem for you.
Now as to trying to get pregnant, your OB is correct and the best opiate to be on during pregnancy is Subutex, however, what is normally done for opioid addicted moms, is that they are transferred to Subutex from whatever opiate they are on, and then tapered off during first two trimesters of pregnancy, so that by delivery, both mom and baby are drug free.
If it is not possible, that the mom is still tapered down to the least amount tolerable and most babied do well being born and nursed on LOW dose buprenorphine.
Consider this, women are so careful with what food, drink and medications they put in their bodies during the pregnancy. The stop eating certain fish, drinking even minute amount of alcohol, caffeine and diet drinks, they stop smoking, etc.... They do things that usually are extremely hard and are usually out of character. You are a strong and a smart woman. You can do it , too. Good luck.
Subutex is the brand name of buprenorphine. Buprenorphine is a thebaine derivative with powerful analgesia approximately 20-40x more potent than morphine. Buprenorphine is a partial agonist and antagonist of the opioid receptors in the central nervous system which means that when its molecule binds to a receptor, it will transduce only a partial response in contrast to a full agonist such as morphine. Buprenorphine also has very high binding to the opioid receptors such that the opioid receptor antagonists (e.g. naloxone) only partially reverse its effects. This means that an overdose of buprenorphine cannot be easily reversed. In the US Subutex has been approved by the FDA for the treatment and control of chronic moderate to severe pain.
If you are using it for treatment of addiction, it was not supposed to be a maintenance medication. The goal of it was to taper that addict relatively quickly, over several months, off of the medication completely.
By reading the above, you may have already understood, that pain control may be an issue during your tonsillectomy. Since buprenorphine has such high affinity to the opioid receptor it will essentially displace, or knock off most other opiates they will try to use during the surgery. Since you already are on a very high dose of buprenorphine your requirement for opiates will be high and most of what they will give will not be sufficient. You might just have to deal with the pain by eating ice cream.
Other anesthetics like gas. propofol and muscle relaxants should not be affected and can be used as usual. So you will sleep through surgery just fine. It is the post operative pain that will be a problem for you.
Now as to trying to get pregnant, your OB is correct and the best opiate to be on during pregnancy is Subutex, however, what is normally done for opioid addicted moms, is that they are transferred to Subutex from whatever opiate they are on, and then tapered off during first two trimesters of pregnancy, so that by delivery, both mom and baby are drug free.
If it is not possible, that the mom is still tapered down to the least amount tolerable and most babied do well being born and nursed on LOW dose buprenorphine.
Consider this, women are so careful with what food, drink and medications they put in their bodies during the pregnancy. The stop eating certain fish, drinking even minute amount of alcohol, caffeine and diet drinks, they stop smoking, etc.... They do things that usually are extremely hard and are usually out of character. You are a strong and a smart woman. You can do it , too. Good luck.
I am pregnant and currently taking Subutex. I'm on a much smaller dosage...chose to stay on it when I got pregnant rather than risk going through withdrawal in my first trimester. My doctor has treated numerous patients while on the medication and all the babies delivered have been healthy
You are reading content posted in the Addiction Forum
Is treating glaucoma with marijuana all hype, or can hemp actually help?
If you think marijuana has no ill effects on your health, this article from Missouri Medicine may make you think again.
Julia Aharonov, DO, reveals the quickest way to beat drug withdrawal.
Tricks to help you quit for good.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
