{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:57:39Z","timestamp":1771977459657,"version":"3.50.1"},"reference-count":57,"publisher":"Weston Medical Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Opioids remain a central element of perioperative pain management despite increased utilization of multimodal adjuvant strategies intended to reduce their use. Contemporary use of methadone and buprenorphine, both conceived as opioid analgesics, is dominated by their essential roles in the treatment of opioid use disorder. Compared to usual care opioids, however, they provide improved post-operative pain control while reducing analgesic requirements. These findings argue for their expanded role within perioperative multimodal analgesia strategies.<\/jats:p>","DOI":"10.5055\/jom.0968","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:02:11Z","timestamp":1771974131000},"page":"29-35","source":"Crossref","is-referenced-by-count":0,"title":["The past is prologue: Reconceptualizing methadone and buprenorphine for post-operative pain"],"prefix":"10.5055","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4890-0238","authenticated-orcid":false,"given":"Thomas R.","family":"Hickey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-5146","authenticated-orcid":false,"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8873-8453","authenticated-orcid":false,"given":"Gregory","family":"Acampora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3008","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"99707","doi-asserted-by":"crossref","unstructured":"Hopkins R, MacLean RR, Pittman B, et al.: Current state of anesthesiology experience with buprenorphine for pain management: Results of a nationwide survey. Reg Anesth Pain Med. 2025; DOI: 10.1136\/rapm-2025-106692.","DOI":"10.1136\/rapm-2025-106692"},{"key":"99708","doi-asserted-by":"crossref","unstructured":"Burns ML, Hilliard P, Vandervest J, et al.: Variation in intraoperative opioid administration by patient, clinician, and hospital contribution. JAMA Netw Open. 2024; 7(1): e2351689. DOI: 10.1001\/jamanetworkopen.2023.51689.","DOI":"10.1001\/jamanetworkopen.2023.51689"},{"key":"99709","doi-asserted-by":"crossref","unstructured":"Bykov K, Patorno E, Franklin JM, et al.: Postoperative inpatient utilization of opioid and opioid-sparing analgesics in the United States hospitals, 2007-2017. Pharmacoepidemiol Drug. 2021; 30(3): 390-394. DOI: 10.1002\/pds.5187.","DOI":"10.1002\/pds.5187"},{"key":"99710","doi-asserted-by":"crossref","unstructured":"Alessio-Bilowus D, Chua KP, Peahl A, et al.: Epidemiology of opioid prescribing after discharge from surgical procedures among adults. JAMA Netw Open. 2024; 7(6): e2417651. DOI: 10.1001\/jamanetworkopen.2024.17651.","DOI":"10.1001\/jamanetworkopen.2024.17651"},{"key":"99711","doi-asserted-by":"crossref","unstructured":"Brummett CM, Waljee JF, Goesling J, et al.: New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg. 2017; 152(6): e170504. DOI: 10.1001\/jamasurg.2017.0504.","DOI":"10.1001\/jamasurg.2017.0504"},{"key":"99712","doi-asserted-by":"crossref","unstructured":"Lee JS, Vu JV, Edelman AL, et al.: Health care spending and new persistent opioid use after surgery. Ann Surg. 2020; 272(1): 99-104. DOI: 10.1097\/sla.0000000000003399.","DOI":"10.1097\/SLA.0000000000003399"},{"key":"99713","doi-asserted-by":"crossref","unstructured":"Agniel D, Brat GA, Marwaha JS, et al.: Association of postsurgical opioid refills for patients with risk of opioid misuse and chronic opioid use among family members. JAMA Netw Open. 2022; 5(7): e2221316. DOI: 10.1001\/jamanetworkopen.2022.21316.","DOI":"10.1001\/jamanetworkopen.2022.21316"},{"key":"99714","doi-asserted-by":"crossref","unstructured":"Siglin J, Sorkin JD, Namiranian K: Incidence of postoperative opioid overdose and new diagnosis of opioid use disorder among US veterans. Am J Addict. 2020; 29(4): 295-304. DOI: 10.1111\/ajad.13022.","DOI":"10.1111\/ajad.13022"},{"key":"99715","doi-asserted-by":"crossref","unstructured":"Lin N, Dabas E, Quan ML, et al.: Outcomes and healthcare utilization among new persistent opioid users and nonopioid users after curative-intent surgery for cancer. Ann Surg. 2023; 277(4): e752-e758. DOI: 10.1097\/sla.0000000000005109.","DOI":"10.1097\/SLA.0000000000005109"},{"key":"99716","unstructured":"National Center for Biotechnology Information (NCBI): PubMed. Bethesda, MD: National Library of Medicine (US) NCfBI. Available at https:\/\/www.ncbi.nlm.nih.gov\/. Accessed June 20, 2025."},{"key":"99717","doi-asserted-by":"crossref","unstructured":"Defalque RJ, Wright AJ: The early history of methadone. Myths and facts. Bull Anesth Hist. 2007; 25(3): 13-16. DOI: 10.1016\/s1522-8649(07)50035-1.","DOI":"10.1016\/S1522-8649(07)50035-1"},{"key":"99718","doi-asserted-by":"crossref","unstructured":"Chem KK: Pharmacology of methadone and related compounds. Ann N Y Acad Sci. 1948; 51(Art 1): 83-97. DOI: 10.1111\/j.1749-6632.1948.tb27252.x.","DOI":"10.1111\/j.1749-6632.1948.tb27252.x"},{"key":"99719","doi-asserted-by":"crossref","unstructured":"Liu J, Smith KE, Riker RR, et al.: Methadone bioavailability and dose conversion implications with intravenous and enteral administration: A scoping review. Am J Health Syst Pharm. 2021; 78(15): 1395-1401. DOI: 10.1093\/ajhp\/zxab166.","DOI":"10.1093\/ajhp\/zxab166"},{"key":"99720","unstructured":"Inturrisi CE: Pharmacology of methadone and its isomers. Minerva Anestesiol. 2005; 71(7-8): 435-437."},{"key":"99721","doi-asserted-by":"crossref","unstructured":"Peckham EM, Traynor JR: Comparison of the antinociceptive response to morphine and morphine-like compounds in male and female Sprague\u2013Dawley rats. J Pharmacol Exp Ther. 2006; 316(3): 1195-1201. DOI: 10.1124\/jpet.105.094276.","DOI":"10.1124\/jpet.105.094276"},{"key":"99722","doi-asserted-by":"crossref","unstructured":"Fishman SM, Wilsey B, Mahajan G, et al.: Methadone reincarnated: Novel clinical applications with related concerns. Pain Med. 2002; 3(4): 339-348. DOI: 10.1046\/j.1526-4637.2002.02047.x.","DOI":"10.1046\/j.1526-4637.2002.02047.x"},{"key":"99723","doi-asserted-by":"crossref","unstructured":"Robinson KM, Eum S, Desta Z, et al.: Clinical pharmacogenetics implementation consortium guideline for CYP2B6 genotype and methadone therapy. Clin Pharma Therap. 2024; 116(4): 932-938. DOI: 10.1002\/cpt.3338.","DOI":"10.1002\/cpt.3338"},{"key":"99724","doi-asserted-by":"crossref","unstructured":"Inturrisi CE: Clinical pharmacology of opioids for pain. Clin J Pain. 2002; 18(4 Suppl): S3-S13. DOI: 10.1097\/00002508-200207001-00002.","DOI":"10.1097\/00002508-200207001-00002"},{"key":"99725","doi-asserted-by":"crossref","unstructured":"Murphy GS, Szokol JW: Intraoperative methadone in surgical patients: A review of clinical investigations. Anesthesiology. 2019; 131(3): 678-692. DOI: 10.1097\/aln.0000000000002755.","DOI":"10.1097\/ALN.0000000000002755"},{"key":"99726","doi-asserted-by":"crossref","unstructured":"Machado FC, Vieira JE, de Orange FA, et al.: Intraoperative methadone reduces pain and opioid consumption in acute postoperative pain: A systematic review and meta-analysis. Anesth Analg. 2019; 129(6): 1723-1732. DOI: 10.1213\/ane.0000000000004404.","DOI":"10.1213\/ANE.0000000000004404"},{"key":"99727","doi-asserted-by":"crossref","unstructured":"Kendall MC, Alves LJ, Pence K, et al.: The effect of intraoperative methadone compared to morphine on postsurgical pain: A meta-analysis of randomized controlled trials. Anesthesiol Res Pract. 2020; 2020: 1-9. DOI: 10.1155\/2020\/6974321.","DOI":"10.1155\/2020\/6974321"},{"key":"99728","doi-asserted-by":"crossref","unstructured":"D'Souza RS, Gurrieri C, Johnson RL, et al.: Intraoperative methadone administration and postoperative pain control: A systematic review and meta-analysis. Pain. 2020; 161(2): 237-243. DOI: 10.1097\/j.pain.0000000000001717.","DOI":"10.1097\/j.pain.0000000000001717"},{"key":"99729","doi-asserted-by":"crossref","unstructured":"Krantz MJ, Martin J, Stimmel B, et al.: QTc interval screening in methadone treatment. Ann Intern Med. 2009; 150(6): 387-395. DOI: 10.7326\/0003-4819-150-6-200903170-00103.","DOI":"10.7326\/0003-4819-150-6-200903170-00103"},{"key":"99730","doi-asserted-by":"crossref","unstructured":"McClain MR, Subramaniam K, Cheema R, et al.: Intraoperative methadone in adult cardiac surgical patients and risks for postoperative QTc prolongation. J Cardiothorac Vasc Anesth. 2025; 39(2): 406-413. DOI: 10.1053\/j.jvca.2024.11.012.","DOI":"10.1053\/j.jvca.2024.11.012"},{"key":"99731","unstructured":"Lewis J: In pursuit of the holy grail. In Proceedings of the 60th Annual Scientific Meeting, the College on Problems of Drug Dependence, Inc. Baltimore, MD: US Dept. of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, 1998: 7-13. Available at https:\/\/permanent.access.gpo.gov\/lps123947\/1998\/LPS123947.pdf. Accessed October 8, 2025."},{"key":"99732","doi-asserted-by":"crossref","unstructured":"Avdeef A, Barrett DA, Shaw PN, et al.: Octanol-, chloroform-, and propylene glycol dipelargonat-water partitioning of morphine-6-glucuronide and other related opiates. J Med Chem. 1996; 39(22): 4377-4381. DOI: 10.1021\/jm960073m.","DOI":"10.1021\/jm960073m"},{"key":"99733","doi-asserted-by":"crossref","unstructured":"Volpe DA, McMahon Tobin GA, Mellon RD, et al.: Uniform assessment and ranking of opioid \u03bc receptor binding constants for selected opioid drugs. Regul Toxicol Pharmacol. 2011; 59(3): 385-390. DOI: 10.1016\/j.yrtph.2010.12.007.","DOI":"10.1016\/j.yrtph.2010.12.007"},{"key":"99734","doi-asserted-by":"crossref","unstructured":"Greenwald MK, Herring AA, Perrone J, et al.: A neuropharmacological model to explain buprenorphine induction challenges. Ann Emerg Med. 2022; 80(6): 509-524. DOI: 10.1016\/j.annemergmed.2022.05.032.","DOI":"10.1016\/j.annemergmed.2022.05.032"},{"key":"99735","doi-asserted-by":"crossref","unstructured":"Webster L, Gudin J, Raffa RB, et al.: Understanding buprenorphine for use in chronic pain: Expert opinion. Pain Med. 2020; 21(4): 714-723. DOI: 10.1093\/pm\/pnz356.","DOI":"10.1093\/pm\/pnz356"},{"key":"99736","doi-asserted-by":"crossref","unstructured":"Coe MA, Lofwall MR, Walsh SL: Buprenorphine pharmacology review: Update on transmucosal and long-acting formulations. J Addict Med. 2019; 13(2): 93-103. DOI: 10.1097\/adm.0000000000000457.","DOI":"10.1097\/ADM.0000000000000457"},{"key":"99737","doi-asserted-by":"crossref","unstructured":"Davis M: Buprenorphine pharmacodynamics: A bridge to understanding buprenorphine clinical benefits. Drugs. 2025; 85(2): 215-230. DOI: 10.1007\/s40265-024-02128-y.","DOI":"10.1007\/s40265-024-02128-y"},{"key":"99738","doi-asserted-by":"crossref","unstructured":"Brown SM, Holtzman M, Kim T, et al.: Buprenorphine metabolites, buprenorphine-3-glucuronide and norbuprenorphine-3-glucuronide, are biologically active. Anesthesiology. 2011; 115(6): 1251-1260. DOI: 10.1097\/ALN.0b013e318238fea0.","DOI":"10.1097\/ALN.0b013e318238fea0"},{"key":"99739","doi-asserted-by":"crossref","unstructured":"Huang P, Kehner GB, Cowan A, et al.: Comparison of pharmacological activities of buprenorphine and norbuprenorphine: Norbuprenorphine is a potent opioid agonist. J Pharmacol Exp Ther. 2001; 297(2): 688-695.","DOI":"10.1016\/S0022-3565(24)29586-0"},{"key":"99740","doi-asserted-by":"crossref","unstructured":"Pande LJ, Arnet RE, Piper BJ: An examination of the complex pharmacological properties of the non-selective opioid modulator buprenorphine. Pharmaceuticals (Basel). 2023; 16(10): 1397. DOI: 10.3390\/ph16101397.","DOI":"10.3390\/ph16101397"},{"key":"99741","doi-asserted-by":"crossref","unstructured":"Dong R, Wang H, Li D, et al.: Pharmacokinetics of sublingual buprenorphine tablets following single and multiple doses in Chinese participants with and without opioid use disorder. Drugs R D. 2019; 19(3): 255-265. DOI: 10.1007\/s40268-019-0277-9.","DOI":"10.1007\/s40268-019-0277-9"},{"key":"99742","doi-asserted-by":"crossref","unstructured":"Hickey TRCG, Oliveira D, Podosek A, et al.: Buprenorphine versus full agonist opioids for acute postoperative pain management: A systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2025: DOI: rapm-2024-106014.","DOI":"10.1136\/rapm-2024-106304"},{"key":"99743","doi-asserted-by":"crossref","unstructured":"Hasoon J, Chitneni A, Viswanath O, et al.: Trends in outpatient buprenorphine prescribing for chronic pain: A retrospective analysis over 18 months. Psychopharmacol Bull. 2025; 55(3): 8-19.","DOI":"10.64719\/pb.4529"},{"key":"99744","doi-asserted-by":"crossref","unstructured":"Schuler MS, Saloner B, Gordon AJ, et al.: National trends in buprenorphine treatment for opioid use disorder from 2007 to 2018. Subst Abus. 2023; 44(3): 154-163. DOI: 10.1177\/08897077231179576.","DOI":"10.1177\/08897077231179576"},{"key":"99745","doi-asserted-by":"crossref","unstructured":"Kohan L, Potru S, Barreveld AM, et al.: Buprenorphine management in the perioperative period: Educational review and recommendations from a multisociety expert panel. Reg Anesth Pain Med. 2021; 46(10): 840-859. DOI: 10.1136\/rapm-2021-103007.","DOI":"10.1136\/rapm-2021-103007"},{"key":"99746","doi-asserted-by":"crossref","unstructured":"Buonora MJ, Mackey K, Khalid L, et al.: Acute pain management in people with opioid use disorder: A systematic review. Ann Intern Med. 2025; 178: 558-570. DOI: 10.7326\/annals-24-01917.","DOI":"10.7326\/ANNALS-24-01917"},{"key":"99747","doi-asserted-by":"crossref","unstructured":"Hickey TRAG: Buprenorphine: An anesthesia-centric review. J Opioid Manag. 2024; 20(6): 503-527. DOI: 10.5055\/jom.0901.","DOI":"10.5055\/jom.0901"},{"key":"99748","doi-asserted-by":"crossref","unstructured":"White LD, Hodge A, Vlok R, et al.: Efficacy and adverse effects of buprenorphine in acute pain management: Systematic review and meta-analysis of randomised controlled trials. Br J Anaesth. 2018; 120(4): 668-678. DOI: 10.1016\/j.bja.2017.11.086.","DOI":"10.1016\/j.bja.2017.11.086"},{"key":"99749","doi-asserted-by":"crossref","unstructured":"Dahan A, Yassen A, Romberg R, et al.: Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006; 96(5): 627-632. DOI: 10.1093\/bja\/ael051.","DOI":"10.1093\/bja\/ael051"},{"key":"99750","doi-asserted-by":"crossref","unstructured":"Bach P, Bawa M, Grant C, et al.: Availability and use of non-prescribed buprenorphine-naloxone in a Canadian setting, 2014-2020. Int J Drug Policy. 2022; 101: 103545. DOI: 10.1016\/j.drugpo.2021.103545.","DOI":"10.1016\/j.drugpo.2021.103545"},{"key":"99751","doi-asserted-by":"crossref","unstructured":"van Dorp E, Yassen A, Sarton E, et al.: Naloxone reversal of buprenorphine-induced respiratory depression. Anesthesiology. 2006; 105(1): 51-57. DOI: 10.1097\/00000542-200607000-00012.","DOI":"10.1097\/00000542-200607000-00012"},{"key":"99752","doi-asserted-by":"crossref","unstructured":"Davis MP: Twelve reasons for considering buprenorphine as a frontline analgesic in the management of pain. J Support Oncol. 2012; 10(6): 209-219. DOI: 10.1016\/j.suponc.2012.05.002.","DOI":"10.1016\/j.suponc.2012.05.002"},{"key":"99753","unstructured":"Abuse NIoD: Medications for opioid use disorder. 2025. Available at https:\/\/nida.nih.gov\/research-topics\/medicationsopioid-use-disorder. Accessed June 13, 2025."},{"key":"99754","doi-asserted-by":"crossref","unstructured":"Kharasch ED, Brunt LM, Blood J, et al.: Intraoperative methadone in next-day discharge outpatient surgery: A randomized, double-blinded, dose-finding pilot study. Anesthesiology. 2023; 139(4): 405-419. DOI: 10.1097\/aln.0000000000004663.","DOI":"10.1097\/ALN.0000000000004663"},{"key":"99755","doi-asserted-by":"crossref","unstructured":"Wyse JJ, Gordon AJ, Dobscha SK, et al.: Medications for opioid use disorder in the department of veterans affairs (VA) health care system: Historical perspective, lessons learned, and next steps. Subst Abus. 2018; 39(2): 139-144. DOI: 10.1080\/08897077.2018.1452327.","DOI":"10.1080\/08897077.2018.1452327"},{"key":"99756","doi-asserted-by":"crossref","unstructured":"Sandbrink F, Murphy JL, Johansson M, et al.: The use of opioids in the management of chronic pain: Synopsis of the 2022 updated US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline. Ann Intern Med. 2023; 176(3): 388-397. DOI: 10.7326\/m22-2917.","DOI":"10.7326\/P22-0030"},{"key":"99757","unstructured":"Veterans Health Administration, Department of Veterans Affairs: Buprenorphine for management of acute pain, national guidance. Washington, DC: VA National Formulary Committee and Pharmacy Benefits Management Services, in Collaboration with National Anesthesia Program Acute Pain Medicine Subcommittee, the Pain Management, Opioid Safety and PDMP Program, National Emergency Medicine Program. Veterans Health Administration, Department of Veterans Affairs. 2025. Available at https:\/\/www.va.gov\/formularyadvisor\/DOC_PDF\/CRE_Buprenorphine_for_ACUTE_pain_RFU_June_2025.pdf. Accessed October 8, 2025."},{"key":"99758","unstructured":"Reckitt Benckiser Healthcare (UK) Ltd: Buprenex [package insert], Hull, England. 2019."},{"key":"99759","doi-asserted-by":"crossref","unstructured":"Abelleira A, Hickey TR: Establishing buprenorphine for acute postoperative pain management. J Pain Palliat Care Pharmacother. 2025; 1-12. DOI: 10.1080\/15360288.2025.2524688.","DOI":"10.1080\/15360288.2025.2524688"},{"key":"99760","unstructured":"Hopkins RKK, Pour AE, Pittman B, et al.: Buccal buprenorphine for postoperative analgesia after major orthopedic surgery: Results of a retrospective cohort. Pain Med Case Rep. 2025; 9(5): 235-241."},{"key":"99761","unstructured":"Hopkins R, Kudaravalli KT, Pittman B, et al.: Buccal buprenorphine for postoperative analgesia after thoracic surgery: Results of a retrospective cohort. Pain Med Case Rep. 2025; 9(5): 269-274."},{"key":"99762","doi-asserted-by":"crossref","unstructured":"Lanham HJ, Papac J, Olmos DI, et al.: Survey of barriers and facilitators to prescribing buprenorphine and clinician perceptions on the drug addiction treatment act of 2000 waiver. JAMA Netw Open. 2022; 5(5): e2212419. DOI: 10.1001\/jamanetworkopen.2022.12419.","DOI":"10.1001\/jamanetworkopen.2022.12419"},{"key":"99763","doi-asserted-by":"crossref","unstructured":"Stone AB, Hughes AP, Soffin EM: Intraoperative methadone and short stay spine surgery: Possible barriers to implementation and future opportunities. J Pain Res. 2022; 15: 2657-2662. DOI: 10.2147\/jpr.S367940.","DOI":"10.2147\/JPR.S367940"}],"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3976\/4260","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3976\/4260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:02:39Z","timestamp":1771974159000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/3976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,24]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.0968","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"value":"1551-7489","type":"electronic"},{"value":"1551-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}