RLS medication and day surgery

[restlegs1]

Hi everyone. I have refractory RLS and am on 2.5 microgram/hour Buprenorphine transdermal patch and one 5mg tablet Methodone daily. I am due to get a basal skin cancer removed on Tuesday next under local anaesthetic. Can anyone suggest anything I need to do so that I don't get a big flare up during or after the operation? The dermatologist does not seem very familiar with dealing with patients on buprenorphine and methodone. When he took a sample for biopsy under a local, I had ongoing pain on the site from just after the last stitch went in. He was surprised at my having pain after a local, until I mentioned the buprenorphine . He had no suggestions about what to do. Fortunately the pain was bearable and went away when I went to sleep, but I might not be so lucky the next time.

[Jelbea]

Hi restlegs1 - I was amazed when I read your post this morning. I am also going on Tuesday next to have a basal cell cancer removed from my right cheek. I had one removed a year ago from my left cheek. It was to be cut out under local anaesthetic but when dermatologist started he decided it was not deep and decided to "scrape" it out instead and then it did not require stitches.

I take 800 mcg buprenorphine sublingual in divided doses each day. I do not remember having any pain after the procedure - only a little discomfort as you would expect.

I am very interested to see any replies to your post as on this occasion I may have to have this one cut out and stitched. I also take blood thinners and dermatologist has told me not to take the one on the evening before to avoid excessive bleeding.

I shall be thinking of you on Tuesday and hope all goes well for you. Best Wishes

[Joolsg]

You can add a pain killer to take for a short period. I had my gallbladder removed recently and I am on 0.4mg Buprenorphine.The hospital gave me paracetamol and ibuprofen for the pain. It worked really well for the week I needed it.

[restlegs1 in reply to Joolsg]

Thanks, Jools, that is very reassuring to know.

[SueJohnson]

I don't have any suggestions for your problem but do wish it goes well.

However your taking methadone along with buprenorphine is a waste since the buprenorphine will block the methadone.

[restlegs1 in reply to SueJohnson]

Hi, Sue, thanks. Yes, I have been wondering about taking the two.I only take the methadone at night The pain specialist I am seeing explained that RLS symptoms occur throughout the day and night, and we may only feel them at night (this is my case), but there is a need for a booster medication at night. Why he did not prescribe an extra dose of buprenorphine to be taken at night I don't know. So far I have been symptom free so taking the two together seems to work. I think he wants to have me on as low a dose as possible, which I am all in favour of. He also put me on 5mg nightly of amitriptyline - I know, it is supposed to exacerbate symptoms, but the funny thing is that I can tolerate it, no symptoms at all. The reason for the amitriptyline, he said, is that even methadone and buprenorphine eventually augment, though the medical term he used for that is different. This process can be slowed down by a very small dose of amitriptyline.

[SueJohnson in reply to restlegs1]

That's ridiculous!!!

Methadone and buprenorphine do not augment and amitriptyline wouldn't affect that even if they did.

And symptoms are what you feel for RLS so if you only experience RLS at night, you only need it at night especially since both at least theoretically last 24 hours.