{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:06:45Z","timestamp":1772168805014,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.13350.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T00:00:00Z","timestamp":1518566400000}}],"reference-count":19,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T00:00:00Z","timestamp":1518566400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background<\/ns4:bold>\n                    : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by \u201cThe American College of Obstetrics and Gynecology\u201d as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial \u03bc-opioid agonists\u2019 unique pharmacology, including its long half time and high affinity to the \u03bc-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods<\/ns4:bold>\n                    : An Institutional Review Board (IRB) approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results<\/ns4:bold>\n                    : Eight women were admitted during this period to our L&amp;D floor on buprenorphine. All required peri-partum anesthetic management either for labor and\/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and\/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA), respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions<\/ns4:bold>\n                    : This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial \u03bc-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.13350.2","type":"journal-article","created":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T03:50:04Z","timestamp":1518580204000},"page":"7","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Management of eight labor and delivery patients dependent on buprenorphine (Subutex\u2122): A retrospective chart review"],"prefix":"10.12688","volume":"7","author":[{"given":"Solina","family":"Tith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garinder","family":"Bining","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7261-8032","authenticated-orcid":false,"given":"Laurent A.","family":"Bollag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2018,2,14]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"1216-24","DOI":"10.1097\/ALN.0000000000000172","article-title":"Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States.","volume":"120","author":"B Bateman","year":"2014","journal-title":"Anesthesiology."},{"key":"ref-2","article-title":"FDA has reviewed possible risks of pain 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Depend."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"53-62","DOI":"10.1111\/j.1360-0443.2012.04039.x","article-title":"Differences in the profile of neonatal abstinence syndrome signs in methadone- versus buprenorphine-exposed neonates.","volume":"107 Suppl 1","author":"D Gaalema","year":"2012","journal-title":"Addiction."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"151-6","DOI":"10.1080\/00952990902825413","article-title":"Management of acute postpartum pain in patients maintained on methadone or buprenorphine during pregnancy.","volume":"35","author":"H Jones","year":"2009","journal-title":"Am J Drug Alcohol Abuse."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"783-789","DOI":"10.1016\/0029-7844(95)00269-W","article-title":"Randomized trial of epidural versus intravenous analgesia during labor.","volume":"86","author":"S Ramin","year":"1995","journal-title":"Obstet 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1996\u20132009.","volume":"21","author":"G Welle-Strand","year":"2015","journal-title":"Eur Addict Res."},{"key":"ref-19","first-page":"16-21","article-title":"Buprenorphine: a new player in neonatal withdrawal syndrome.","volume":"111","author":"S Nanda","year":"2015","journal-title":"W V Med 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.14490.r29456, Emily J. Baird, Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA, 01 Feb 2018, version 1, 1 approved","URL":"https:\/\/f1000research.com\/articles\/7-7\/v1#referee-response-29456","order":0,"name":"referee-response-29456","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.15197.r30882, Allison J. Lee, Department of Anesthesiology, Columbia University Medical Center , New York City, NY, USA, 19 Feb 2018, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/7-7\/v2#referee-response-30882","order":1,"name":"referee-response-30882","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}