Procedural Sedation and Endoscopy
Considerations for management of procedural sedation in methadone and buprenorphine maintenance patients:
Follow the above principles for acute pain management in opioid tolerant patients – they will require more analgesics than the opioid naive. Titrate to effect.
Specific considerations for methadone maintenance patients:
Benzodiazepines significantly increase the chance of respiratory depression
Specific considerations for buprenorphine maintenance patients:
Benzodiazepines are less dangerous because of the respiratory ”ceiling effect” of buprenorphine