• A & A case reports · Oct 2017

    Perioperative Pain Management of a Patient Taking Naltrexone HCl/Bupropion HCl (Contrave): A Case Report.

    • Allen Ninh, Sang Kim, and Andrew Goldberg.
    • From the Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York.
    • A A Case Rep. 2017 Oct 15; 9 (8): 224-226.

    AbstractA 42-year-old obese woman (body mass index = 30.2 kg/m) presented for urgent anterior cervical diskectomy and fusion. She had been taking oral naltrexone-bupropion extended-release (Contrave, Orexigen Therapeutics Inc, La Jolla, CA) for the past 6 months and continued using it until 12 hours preoperatively. Despite discontinuation of this medication, and employing an intraoperative and postoperative multimodal analgesia strategy, immediate pain control was inadequately achieved. Patients taking opioid antagonists who present for surgery pose unique challenges to the anesthesiologist and require extensive preoperative interdisciplinary discussions and planning for pain control throughout the perioperative period.

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