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Abstract

1. 2024;8;13-15 Buprenorphine Microinduction to Mitigate Withdrawal Symptoms During Abrupt Discontinuation of Intrathecal Fentanyl: A Case Report
   Case Report
   Elizabeth Pinchman, MBA, Arnold Moore, III, MBA, Lyncee Barrett, FNP-BC, John Paul Pianka, MD, and Ravneet Bhullar, MD.

BACKGROUND: Intrathecal pumps provide effective analgesia for many patients living with chronic pain. However, pump removal can present significant challenges from the pain management perspective, as patients are often highly opioid-tolerant and at significant risk of withdrawal. Buprenorphine microinduction has shown promise as a strategy for mitigating withdrawal symptoms while avoiding the respiratory depression associated with full agonist opioids. However, reports of its usage in patients undergoing intrathecal pump removal are limited.

CASE REPORT: We present the case of a 56-year-old woman with chronic non-cancer back pain who was successfully transitioned to oral buprenorphine using a microinduction protocol when her longstanding intrathecal pump was abruptly discontinued.

CONCLUSIONS: This case demonstrates that buprenorphine microinduction may be a safe and effective method of mitigating opioid withdrawal symptoms in non-cancer pain patients undergoing abrupt intrathecal pump discontinuation.

KEY WORDS: Intrathecal pump, buprenorphine, chronic pain

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