The use of buprenorphine, a mixed opioid agonist-antagonist, for the management of chronic pain and/or opioid use disorder is increasing. As such, medical providers will more frequently encounter patients on this therapy. In this paper, we synthesize existing knowledge (derived through keyword searches using MEDLINE databases) in a novel conceptual framework for patients on buprenorphine presenting with acute pain or for those requiring surgical or invasive procedures. This framework is based on three unique domains: the patient, the features of the acute pain insult, and the environment. We discuss important considerations regarding the unique aspects of buprenorphine formulations and dosing, and we describe the importance of multidisciplinary planning and multimodal analgesic strategies. We also highlight important differences in management strategies based upon the presence or absence of opioid use disorder. All medical providers must be prepared to guide the patient on buprenorphine safely through the acute care episode, which includes adequate treatment of acute pain and avoidance of iatrogenic harm, including both short-term complications (eg, respiratory depression) and long-term complications (eg, relapse to opioid use).

丁丙诺啡（一种混合的阿片类激动剂-拮抗剂）用于治疗慢性疼痛和/或阿片类药物使用障碍的现象正在增加。这样，医疗提供者将更频繁地在这种疗法上遇到患者。在本文中，我们在一个新的概念性框架中综合了现有知识（通过使用MEDLINE数据库通过关键字搜索得出），用于患有丁丙诺啡的急性疼痛患者或需要手术或侵入性治疗的患者。该框架基于三个独特的领域：患者，急性疼痛侮辱的特征和环境。我们讨论了有关丁丙诺啡配方和给药方式独特方面的重要考虑因素，并描述了多学科规划和多峰镇痛策略的重要性。我们还强调了基于存在或不存在阿片类药物使用障碍的管理策略的重要差异。所有医疗人员都必须做好准备，以在急性护理发作期间安全地指导患者使用丁丙诺啡，其中包括对急性疼痛的适当治疗和避免医源性伤害，包括短期并发症（例如呼吸抑制）和长期并发症（例如复发至使用阿片类药物）。