Kratom and opioid use disorder in the perioperative period: A case report on the expanding role of buprenorphine.

Kratom (Mitragyna speciosa), an herbal plant gaining popularity as a treatment for chronic pain and opioid withdrawal symptoms, continues to be marketed and sold in the United States in an unregulated fashion. We present a patient with a history of opioid use disorder and taking kratom for chronic pain, who presented for an elective total knee replacement. We experienced challenges as well as successes with using buprenorphine as the primary medication to treat his post-operative pain, adding to the growing body of evidence to consider the use of buprenorphine both for kratom withdrawal and in the perioperative period.