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Opioid management

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https://www.readbyqxmd.com/read/27905910/is-standardized-care-feasible-in-the-emergency-setting-a-case-matched-analysis-of-patients-undergoing-laparoscopic-cholecystectomy
#1
Fabian Grass, Matthieu Cachemaille, Catherine Blanc, Nicolas Fournier, Nermin Halkic, Nicolas Demartines, Martin Hübner
BACKGROUND: Immediate laparoscopic cholecystectomy is the accepted standard for the treatment of acute cholecystitis. The aim of the present study was to evaluate the feasibility of a standardized approach with tailored care maps for pre- and postoperative care by comparing pain, nausea and patient satisfaction after elective and emergent laparoscopic cholecystectomy. METHODS: From January 2014 until April 2015, data on pain and nausea management were prospectively recorded for all elective and emergency procedures in the department of visceral surgery...
December 1, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27904951/pre-emptive-injection-of-peri-articular-multimodal-drug-for-post-operative-pain-management-in-total-knee-arthroplasty-a-double-blind-randomized-clinical-trial
#2
Mahdi Motififard, Ali Omidian, Sajad Badiei
PURPOSE: Severe post-operative pain is one of the main problems after total knee arthroplasty. In this study, we investigated the effect of a peri-articular multimodal drugs injections pre-emptively on post-operative pain control and knee functions following total knee arthroplasty. METHODS AND MATERIALS: This study was a double-blind randomized clinical trial. Eligible cases including 137 patients-aged 30 to 80 years old-were randomly divided into one of two groups: the drug group received a cocktail consisting of bupivacaine hydrochloride, morphine sulphate, epinephrine, and ketorolac...
November 30, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27903034/prescription-drug-abuse-a-timely-update
#3
Benny Monheit, Danusia Pietrzak, Sandra Hocking
BACKGROUND: Prescription drug abuse is a rising problem in Australia and pharmaceutical drugs have been the most frequent contributors to overdose deaths in Victoria in recent years. OBJECTIVE: The objectives of this article are to examine the main prescription drugs contributing to overdose deaths and to consider how doctors may help in reducing this problem. DISCUSSION: Data from the Coroners Court of Victoria list the main drugs that contributed to drug-related deaths in 2009-15...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27900781/the-present-and-future-of-opioid-analgesics-in-small-animal-practice
#4
REVIEW
B T Simon, P V Steagall
Opioids are the cornerstone for the treatment of acute pain in small animal patients. This is primarily because of their remarkable safety profile, high efficacy, and benefit of reversibility. There have been some significant advances in our knowledge on opioid pharmacology and clinical usage in companion animal medicine. This review discusses the progression of opioid use in small animal practice providing current misconceptions and controversies in light of routes of administration. Potential targets for research and drug development and novel therapies are discussed in addition to the concepts of glial cell modulators, individual variability, and opioid tolerance and hyperalgesia...
November 30, 2016: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27899254/thalidomide-attenuates-the-development-and-expression-of-antinociceptive-tolerance-to-%C3%AE-opioid-agonist-morphine-through-l-arginine-inos-and-nitric-oxide-pathway
#5
Muhammad Imran Khan, Sattar Ostadhadi, Faiza Mumtaz, Majid Momeny, Farima Moghaddaskho, Mahsa Hassanipour, Shahram Ejtemaei-Mehr, Ahmad Reza Dehpour
Morphine is a μ-opioid analgesic drug which is used in the treatment and management of chronic pain. However, due to development of antinociceptive tolerance its clinical use is limited. Thalidomide is an old glutamic acid derivative which recently reemerged because of its potential to counteract a number of disorders including neurodegenerative disorders. The potential underlying mechanisms and effects of thalidomide on morphine-induced antinociceptive tolerance is still elusive. Hence, the present study was designed to explore the effect of thalidomide on the development and expression of morphine antinociceptive tolerance targeting l-arginine-nitric oxide (NO) pathway in mice and T98G human glioblastoma cell line...
November 26, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27899200/-mucoadhesive-buccal-films-of-tramadol-for-effective-pain-management
#6
Xiao-Qin Li, Zhao-Ming Ye, Jian-Bing Wang, Cai-Rong Fan, Ai-Wu Pan, Cong Li, Ren-Bing Zhang
BACKGROUND AND OBJECTIVES: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. METHODS: Buccal films of tramadol hydrochloride were prepared by solvent casting method...
November 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#7
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27898491/psychosocial-factors-predict-opioid-analgesia-via-endogenous-opioid-function
#8
John W Burns, Stephen Bruehl, Christopher R France, Erik Schuster, Daria Orlowska, Asokumar Buvanendran, Melissa Chont, Rajnish K Gupta
Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (e.g. depressive symptoms) predicted changes in spontaneous low back pain following administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in three (counterbalanced) conditions: 1) placebo, 2) intravenous naloxone, 3) intravenous morphine...
November 18, 2016: Pain
https://www.readbyqxmd.com/read/27898139/farmakologisk-sm%C3%A3-rtlindring-har-central-roll-i-palliativ-v%C3%A3-rd-sm%C3%A3-rtfrihet-i-vila-och-acceptabel-natts%C3%A3-mn-%C3%A3-r-m%C3%A3-let-f%C3%A3-r-behandlingen-%C3%A2-som-b%C3%A3-r-individualiseras
#9
Staffan Lundström
Mechanism-based pain treatment in palliative care Pain is common among patients in palliative care and one of the most feared symptoms. Knowledge about effective pain management is therefore essential for clinicians. Successful pain management is mainly based on the medical history and clinical examination, resulting in an understanding of the present pain mechanism(s). The pain mechanism then forms the basis for the pharmacological treatment strategy which should be individualized and take into account factors such as kidney function, expected side effects, route of administration and concomitant medication...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27898136/pharmacological-approaches-for-the-management-of-persistent-pain-in-older-adults-what-nurses-need-to-know
#10
Fabio Guerriero, Ruth Bolier, Janet H Van Cleave, M Cary Reid
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898135/complementary-and-integrative-therapies-for-persistent-pain-management-in-older-adults-a-review
#11
Patricia Bruckenthal, Marie Ann Marino, Lisa Snelling
Management of persistent pain in older adults is challenging given the prevalence of multiple comorbid painful conditions, polypharmacy, age-related changes restricting pharmacological options, and socioeconomic factors. The influences of these factors along with current concern for the use of opioid analgesics highlight the importance of incorporating complementary and integrative medicine approaches. Evidence suggests efficacy and satisfaction with integrating complementary pain management strategies for older adults, especially yoga, massage, and natural products...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#12
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#13
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898127/the-opioid-epidemic-and-persistent-pain-management-in-older-adults
#14
EDITORIAL
Keela Herr, Paul Arnstein
No abstract text is available yet for this article.
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#15
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27895505/evaluating-increased-resource-use-in-fibromyalgia-using-electronic-health-records
#16
Jay M Margolis, Elizabeth T Masters, Joseph C Cappelleri, David M Smith, Steven Faulkner
OBJECTIVE: The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR) database to explore data from patients diagnosed with FM. METHODS: This was a retrospective analysis of de-identified EHR data from the Humedica database...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#17
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27893147/update-on-the-pharmacology-and-legal-status-of-kratom
#18
Walter C Prozialeck
Kratom (Mitragyna speciosa) is a plant indigenous to Southeast Asia. Its leaves and the teas brewed from them have long been used by people in that region to stave off fatigue and to manage pain and opioid withdrawal. In a comprehensive review published in 2012, Prozialeck et al presented evidence that kratom had been increasingly used for the self-management of opioid withdrawal and pain in the United States. At the time, kratom was classified as a legal herbal product by the US Drug Enforcement Administration...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27889436/wide-variation-found-in-care-of-opioid-exposed-newborns
#19
Debra L Bogen, Bonny L Whalen, Laura R Kair, Mark Vining, Beth A King
OBJECTIVE: Standardized practices for the management of neonatal abstinence syndrome (NAS) are associated with shorter lengths of stay, but optimal protocols are not established. We sought to identify practice variations for newborns with in utero chronic opioid exposure among hospitals in the Better Outcomes Through Research for Newborns (BORN) network. METHODS: Nursery site leaders completed a survey about hospitals' policies and practices regarding care for infants with chronic opioid exposure (≥3 weeks)...
November 23, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27884220/multimodal-pain-management-for%C3%A2-enhanced-recovery-reinforcing-the-shift-from-traditional-pathways-through-nurse-led-interventions
#20
Robert Montgomery, Sharon A McNamara
Despite recent advances in perioperative patient care, postsurgical pain continues to be undermanaged. There is increasing acceptance of the concept that effective postsurgical pain management is best achieved through combined use of more than one analgesic agent or technique, and overreliance on opioids produces unwanted side effects limiting their utility. Accordingly, a balanced, multimodal approach to pain management within the larger framework of an Enhanced Recovery After Surgery (ERAS) pathway has become standard at many institutions for perioperative care, to control postsurgical pain, reduce opioid-related adverse events, hasten postsurgical recovery, and shorten length of hospital stay...
December 2016: AORN Journal
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