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Eeva Kormi, Johanna Snäll, Anna-Maria Koivusalo, Anna Liisa Suominen, Hanna Thorén, Jyrki Törnwall
PURPOSE: To clarify the effect of systemic dexamethasone (DXM) on pain and postoperative opioid (oxycodone) consumption after blowout fracture surgery. MATERIALS AND METHODS: A prospective randomized observer-blinded trial of 20 patients who had a blowout fracture requiring surgical intervention was conducted. Patients were randomly assigned to receive a total dose of intravenous DXM 30 mg perioperatively or no DXM (controls). Pain was assessed postoperatively using a 10-cm visual analog scale (VAS) each time analgesics (acetaminophen every 6 hours or oxycodone upon request) were administered...
September 26, 2016: Journal of Oral and Maxillofacial Surgery
R Brent Dixon, Amitava Dasgupta
BACKGROUND: We evaluated the analytical performance of the DRI hydrocodone/hydromorphone assay by comparing semi-quantitative values obtained by this assay with values obtained by a liquid chromatography combined with tandem mass spectrometry (LC-MS/MS) method. We also evaluated the possibility of lowering the cutoff of the DRI assay from 300 to 100 ng/mL. MATERIALS AND METHODS: We compared semi-quantitative values obtained by the DRI assay in 97 specimens with values obtained by using the LC-MS/MS method including 10 specimens containing hydrocodone and/ or hydromorphone concentrations between 105...
October 19, 2016: Therapeutic Drug Monitoring
Pamela Leece, Margaret Gassanov, Shaun Hopkins, Chantel Marshall, Peggy Millson, Rita Shahin
SETTING: A harm reduction program at a public health unit in Toronto, Ontario, between August 31, 2011 and August 31, 2013. INTERVENTION: We conducted a process evaluation of the first two years of an opioid overdose prevention and response program, Prevent Overdose in Toronto (POINT), including analysis of data from program documentation forms, as well as qualitative interviews with program staff, representatives from partner agencies, and program clients. OUTCOMES: In the first two years of the program, 662 individuals (52...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
F Creamer, A Balfour, S Nimmo, I Foo, J D Norrie, L J Williams, K C Fearon, H M Paterson
BACKGROUND: Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. METHODS: In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance...
October 20, 2016: British Journal of Surgery
Pratik Naik, Laura Cashin, Sonny Huitron
Foreign body granulomatosis is a rare complication of intravenous injection of pulverized oral prescription tablets. We present the case of an active duty male who was ultimately diagnosed with foreign body granulomatosis caused by the crushing and intravenous injection of acetaminophen with oxycodone (Percocet). The 24-year-old patient initially presented with multiple syncopal episodes, hemoptysis and hypoxia. The patient presentation and imaging findings involved in foreign body granulomatosis can mimic many pulmonary disorders and can be widely variable...
October 2016: Military Medicine
D Lelic, I W D Fischer, A E Olesen, C D Mørch, F G Arguissain, J A B Manresa, A Dahan, A M Drewes
Severe pain is often treated with opioids. Antidepressants that inhibit serotonin and norepinephrine reuptake (SNRI) have also shown a pain relieving effect, but for both SNRI and opioids the specific mode of action in humans remains vague. This study investigated how oxycodone and venlafaxine affect spinal and supraspinal pain processing. Twenty volunteers were included in this randomized cross-over study comparing five-day treatment with venlafaxine, oxycodone and placebo. As a proxy of the spinal pain transmission, the nociceptive withdrawal reflex (NWR) to electrical stimulation on the sole of the foot was recorded at the tibialis anterior muscle before and after five days of treatment...
October 17, 2016: European Journal of Neuroscience
Na Wang, Honglan Zhou, Xuesong Song, Jinguo Wang
BACKGROUND: Sufentanil is widely used for patient-controlled intravenous analgesia (PCIA). Oxycodone has a powerful analgesic effect and mild side effects. We conducted this study to compare the efficacy of oxycodone and sufentanil for PCIA on postoperative pain after laparoscopic radical gastrectomy. METHODOLOGY: A total of fifty patients scheduled for laparoscopic radical gastrectomy were equally randomized to receive postoperative pain treatment with either oxycodone (Group O) or sufentanil (Group S) for 48 h postoperatively...
September 2016: Anesthesia, Essays and Researches
Tonje A Sande, Barry J A Laird, Marie T Fallon
PURPOSE: Opioids are recommended for moderate to severe cancer pain; however, in patients with cancer, impaired renal function can affect opioid metabolism. The aim of this systematic review was to evaluate the current evidence for the use of opioids in cancer patients with renal impairment. METHODS: A systematic review was conducted and the following databases were searched: MEDLINE (1966 to 2015), EMBASE (1980 2015) and Cochrane Central Register of Controlled Trials (up to 2015)...
October 15, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Georges Daccache, Edouard Caspersen, Michel Pegoix, Kelly Monthé-Sagan, Ludovic Berger, Dominique Fletcher, Jean-Luc Hanouz
BACKGROUND: The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0-100 index derived from heart rate variability analysis, has been proposed for nociception assessment. However, the ability of the ANI to adequately guide intraoperative opioid administration has never been demonstrated. We designed a prospective study to evaluate the ability of the ANI to guide remifentanil administration in vascular surgery...
October 12, 2016: Anaesthesia, Critical Care & Pain Medicine
Ernesto Zecca, Cinzia Brunelli, Paola Bracchi, Giuseppe Biancofiore, Carlo De Sangro, Roberto Bortolussi, Luigi Montanari, Marco Maltoni, Cecilia Moro, Ugo Colonna, Gabriele Finco, Maria Teresa Roy, Vittorio Ferrari, Oscar Alabiso, Giovanni Rosti, Stein Kaasa, Augusto Caraceni
: Context Oxycodone and morphine are recommended as first-choice opioids for moderate/severe cancer pain but evidence about their relative tolerability has significant methodological limitations. OBJECTIVES: This study is mainly aimed at comparing the risk of developing adverse events (AEs) with controlled release oral morphine versus oxycodone; secondary aims were comparing their analgesic efficacy and testing heterogeneity in tolerability across different age and renal function subgroups...
October 11, 2016: Journal of Pain and Symptom Management
William J Warrender, Usman Ali M Syed, Sommer Hammoud, William Emper, Michael G Ciccotti, Joseph A Abboud, Kevin B Freedman
BACKGROUND: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction. PURPOSE: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery. STUDY DESIGN: Systematic review. METHODS: We performed a systematic review of the various modalities reported in the literature for postoperative pain control after outpatient shoulder arthroscopy and analyzed their outcomes...
October 11, 2016: American Journal of Sports Medicine
Yan J Bao, Wei Hou, Xiang Y Kong, Liping Yang, Jun Xia, Bao J Hua, Roger Knaggs
BACKGROUND: Cancer pain is an important and distressing symptom that tends to increase in frequency and intensity as the cancer advances. For people with advanced cancer, the prevalence of pain can be as high as 90%. It has been estimated that 30% to 50% of people with cancer categorise their pain as moderate to severe, with between 75% and 90% of people with cancer experiencing pain that they describe as having a major impact on their daily life. Epidemiological studies suggest that approximately 15% of people with cancer pain fail to experience acceptable pain relief with conventional management...
October 11, 2016: Cochrane Database of Systematic Reviews
Young Suk Kwon, Ji Su Jang, Na Rea Lee, Seong Su Kim, Young Ki Kim, Byeong Mun Hwang, Seong Sik Kang, Hee Jeong Son, So Young Lim
Background. Oxycodone, a semisynthetic opioid, has been widely used for acute and chronic pain. Objectives. The aim of this study was to compare the analgesic and adverse effects of oxycodone and alfentanil on postoperative pain after laparoscopic cholecystectomy. Methods. This was a prospective, randomized, double-blind study. A total of 82 patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either oxycodone or alfentanil using intravenous patient-controlled analgesia (PCA). PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass for 48 hours postoperatively...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Zhonghua Li, Honglian Wu, Renhong He, Xiaowei Hu, Shaoxiao Liu
OBJECTIVE: The aim of this study was to evaluate oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery. MATERIALS AND METHODS: Fifty-one cases of cervical cancer treated with radical surgery were included in the present study and divided into oxycodone group (n = 26) and dezocine group (n = 25). Patients in the oxycodone group were given with oxycodone 1 mg/kg plus tropisetron 0.1 mg/kg diluting to 100 ml by 0...
October 2016: Journal of Cancer Research and Therapeutics
Ruliang Wang, Zefei Jiang, Shaohua Zhang, Jizheng Tian, Tao Wang, Santai Song
To investigate the changes in bone metabolism markers after second-line treatment with loading-dose intravenous (I.V.) ibandronate in patients with bone metastases (BM) from breast cancer, 80 patients were enrolled in this study during January 2010 to April 2014. All the patients were treated with a second-line loading dose ibandronate for advanced breast cancer with BM and moderate-to-severe bone pain. Ibandronate was (6 mg) intravenously administered on 3 consecutive days followed by maintenance treatment every 3-4 weeks...
September 22, 2016: Clinical and Experimental Pharmacology & Physiology
Stevan Geoffrey Severtson, Matthew S Ellis, Steven P Kurtz, Andrew Rosenblum, Theodore J Cicero, Mark W Parrino, Michael K Gilbert, Mance E Buttram, Nabarun Dasgupta, Becki BucherBartelson, Jody L Green, Richard C Dart
BACKGROUND: The development of abuse deterrent formulations is one strategy for reducing prescription opioid misuse and abuse. A putative abuse deterrent formulation of oxycodone extended release (OxyContin(®)) was introduced in 2010. Early reports demonstrated reduced abuse and diversion, however, an analysis of social media found 32 feasible methods to circumvent the abuse deterrent mechanism. We measured trends of diversion, abuse and street price of OxyContin to assess the durability of the initial reduction in abuse...
October 3, 2016: Drug and Alcohol Dependence
Athir H Morad, Rafael J Tamargo, Allan Gottschalk
OBJECTIVE: The purpose of this study was to determine the duration, intensity, location, and usual treatment of pain throughout hospitalization following subarachnoid hemorrhage. BACKGROUND: Headache following subarachnoid hemorrhage can be sudden and severe. Little is known about the longitudinal course of headache or its analgesic therapy following the initial diagnosis of subarachnoid hemorrhage. METHODS: A prospectively maintained database of 564 patients diagnosed with cerebral aneurysms collected from 10/2009 to 2/2013 was searched for conscious patients with subarachnoid hemorrhage...
October 5, 2016: Headache
Elizabeth Marrett, Winghan Jacqueline Kwong, Feride Frech, Chunlin Qian
INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan. METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (≤15-day supply) between October 1, 2013 and September 30, 2014...
October 4, 2016: Pain and Therapy
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
Pongkwan Sitasuwan, Cathleen Melendez, Margarita Marinova, Kaylee R Mastrianni, Alicia Darragh, Emily Ryan, L Andrew Lee
Drug monitoring laboratories utilize a hydrolysis process to liberate the opiates from their glucuronide conjugates to facilitate their detection by tandem mass spectrometry (MS). Both acid and enzyme hydrolysis have been reported as viable methods, with the former as a more effective process for recovering codeine-6-glucuronide and morphine-6-glucuronide. Here, we report concerns with acid-catalyzed hydrolysis of opioids, including a significant loss of analytes and conversions of oxycodone to oxymorphone, hydrocodone to hydromorphone and codeine to morphine...
October 2016: Journal of Analytical Toxicology
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