. Author manuscript; available in PMC: 2019 May 17.

Published in final edited form as: Anesth Analg. 2018 Aug;127(2):539–547. doi: 10.1213/ANE.0000000000003477

Table 5.

Perioperative Pain Management of Patients With OUD on Injectable Naltrexone

	Preoperative Planning	Inpatient Management	Discharge Planning
Patients with OUD on injectable naltrexone	Contact naltrexone provider	For elective surgeries, consider close observation to monitor response to opioids.	Coordinate with provider for restart of naltrexone
	Involve patient, provider, and support person for decisions regarding pain management, discuss risk of relapse	Consider adjuncts	Consider OPENP
	Stop naltrexone presurgery	For emergency surgery, consider pain management with nonopioid strategies such as regional anesthesia and analgesia, systemic nonopioid agents, and nonpharmacological interventions
	>72 h for tablet
	>4 wk for injection
	Consider APS, SUD consult

Abbreviations: APS, acute pain service; OPENP overdose prevention education and naloxone prescription; OUD, opioid use disorder; SUD, substance use disorder.