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https://www.readbyqxmd.com/read/28813550/drug-free-interventions-to-reduce-pain-or-opioid-consumption-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#1
Dario Tedesco, Davide Gori, Karishma R Desai, Steven Asch, Ian R Carroll, Catherine Curtin, Kathryn M McDonald, Maria P Fantini, Tina Hernandez-Boussard
Importance: There is increased interest in nonpharmacological treatments to reduce pain after total knee arthroplasty. Yet, little consensus supports the effectiveness of these interventions. Objective: To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. Data Sources: Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Web of Science (ISI database), Physiotherapy Evidence (PEDRO) database, and ClinicalTrials...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28813190/under-pressure-the-tension-between-access-and-abuse-of-opioids-in-cancer-pain-management
#2
Judith A Paice
No abstract text is available yet for this article.
August 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28810899/chronic-pain-and-opioid-misuse-a-review-of-reviews
#3
REVIEW
Pauline Voon, Mohammad Karamouzian, Thomas Kerr
OBJECTIVE: The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse. METHODS: A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Eligible studies were systematic reviews related to chronic non-cancer pain and PO or other substance misuse...
August 15, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28810127/medicaid-prior-authorization-and-opioid-medication-abuse-and-overdose
#4
Gerald Cochran, Adam J Gordon, Walid F Gellad, Chung-Chou H Chang, Wei-Hsuan Lo-Ciganic, Carroline Lobo, Evan Cole, Winfred Frazier, Ping Zheng, David Kelley, Julie M Donohue
OBJECTIVES: The US opioid medication epidemic has resulted in serious health consequences for patients. Formulary management tools adopted by payers, specifically prior authorization (PA) policies, may lower the rates of opioid medication abuse and overdose. We compared rates of opioid abuse and overdose among enrollees in plans that varied in their use of PA from "High PA" (ie, required PA for 17 to 74 opioids), with "Low PA" (ie, required PA for 1 opioid), and "No PA" policies for opioid medications...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28808946/perioperative-care-of-elderly-surgical-outpatients
#5
REVIEW
Xuezhao Cao, Paul F White, Hong Ma
The ambulatory setting offers potential advantages for elderly patients undergoing elective surgery due to the advancement in both surgical and anesthetic techniques resulting in quicker recovery times, fewer complications, higher patient satisfaction, and reduced costs of care. This review article aims to provide a practical guide to anesthetic management of elderly outpatients. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative complications (e...
August 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28808081/%C3%A2-eluxadoline-for-ibs-d
#6
(no author information available yet)
Irritable bowel syndrome (IBS) is a chronic relapsing gastrointestinal problem characterised by intestinal pain and associated alterations of defecation and/or bowel habit (constipation: IBS-C or diarrhoea: IBS-D).(1,2) Opioid receptors in the gut have a role in gastrointestinal motility, secretion and sensation.(3) Τ Eluxadoline (Truberzi-Allergan) is a locally acting, mixed opioid receptor agonist/antagonist licensed for the treatment of IBS-D in adults.(4) Here, we consider the evidence for eluxadoline and how it fts with current management strategies for IBS-D...
August 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28807047/adverse-outcomes-associated-with-opioid-prescription-for-acute-low-back-pain-a-systematic-review-protocol
#7
Natalia Mouravska, Laura Zielinski, Meha Bhatt, Nitika Sanger, Monica Bawor, Brittany Dennis, Laura Banfield, James MacKillop, James Paul, Andrew Worster, Philip Laplante, Lehana Thabane, Zainab Samaan
BACKGROUND: Acute low back pain (ALBP) is the top cause of global disability, demonstrating a significant impact on individuals and society and demanding the need for appropriate management. There is a trend towards an increasing number of opioid prescriptions for ALBP despite the lack of investigation for its various short- and long-term outcomes. The objective of this review is to examine adverse outcomes associated with opioid use for ALBP. METHODS/DESIGN: Using a search strategy, the search will be conducted using the following electronic databases: PubMed/MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Cochrane Library, the National Institutes for Health Clinical Trials Registry and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP)...
August 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#8
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28806561/delirium-and-exposure-to-psychoactive-medications-in-critically-ill-adults-a-multi-centre-observational-study
#9
Lisa D Burry, David R Williamson, Sangeeta Mehta, Marc M Perreault, Ioanna Mantas, Ranjeeta Mallick, Dean A Fergusson, Orla Smith, Eddy Fan, Sebastien Dupuis, Margaret Herridge, Louise Rose
PURPOSE: Investigate the relationship between psychoactive drugs and delirium. MATERIALS AND METHODS: Prospective observational study of 520 critically ill adult patients admitted ≥24h to 6 intensive care units (ICUs). Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4). RESULTS: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806211/the-opiorphin-analog-str-324-decreases-sensory-hypersensitivity-in-a-rat-model-of-neuropathic-pain
#10
Alain Van Elstraete, Philippe Sitbon, Leila Hamdi, Victor Juarez-Perez, Jean-Xavier Mazoit, Dan Benhamou, Catherine Rougeot
BACKGROUND: Neuropathic pain represents a therapeutic challenge, and treatments with increased efficacy and tolerability still need to be developed. Opiorphin protects endogenous enkephalins from degradation, potentiating enkephalin-dependent analgesia via the activation of opioid pathways. Enkephalins are natural ligands of opioid receptors, with strong affinity for δ-opioid receptors. Expression of functional δ-opioid receptors increases in sensory neurons after peripheral nerve injury in neuropathic pain models...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28803088/treat-the-pain-program
#11
Megan O'Brien, Amanda Schwartz, Laura Plattner
CONTEXT: Globally, low and middle-income countries are home to 70% of cancer deaths and 99% of HIV deaths, but they consume just 7% of opioid analgesics. OBJECTIVE: The American Cancer Society's Treat the Pain program partners with governments in low and middle-income countries to improve access to high-quality essential pain medicines. METHOD: Treat the Pain has developed the MORPHINE Framework to provide a structure to describe challenges to access to pain relief and to group and sequence interventions to address these challenges...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803083/the-impact-of-combined-use-of-opioids-antipsychotics-and-anxiolytics-on-survival-in-the-hospice-setting
#12
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Aleksandar Čubranić
CONTEXT: Opioids and sedatives are the cornerstone of symptom management in the end-of-life patients, but undertreatment is a common problem. Although several studies explored the individual effect of opioids, anxiolytics and antipsychotics on survival, not much is known regarding their combined use. As these drugs share similar and potentially fatal side effects, primarily respiratory depression which occurs more often during night-hours, it is crucial to explore whether their interaction poses a danger for fragile hospice patients...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803078/safety-and-effectiveness-of-palliative-drug-treatment-in-the-last-days-of-life-a-systematic-literature-review
#13
REVIEW
Kristian Jansen, Dagny Faksvåg Haugen, Lisa Pont, Sabine Ruths
CONTEXT: Dying patients commonly experience potentially distressing symptoms. Palliative care guidelines recommend opioids, anticholinergics, antipsychotics and benzodiazepines for symptom relief. OBJECTIVES: To systematically review the effectiveness and safety of palliative drug treatment in the last days of life of adult patients, focusing on the management of pain, dyspnea, anxiety, restlessness, and death rattle. METHODS: A systematic search of the literature published before December 2016 in PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane, ClinicalTrials...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802777/local-infiltration-analgesia-with-liposomal-bupivacaine-improves-pain-scores-and-reduces-opioid-use-after-total-knee-arthroplasty-results%C3%A2-of-a-randomized-controlled-trial
#14
Michael A Mont, Walter B Beaver, Stanley H Dysart, John W Barrington, Daniel J Del Gaizo
BACKGROUND: Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. METHODS: Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802618/is-gabapentin-effective-and-safe-in-open-hysterectomy-a-prisma-compliant-meta-analysis-of-randomized-controlled-trials
#15
REVIEW
Xiao-Dan Li, Chao Han, Wen-Li Yu
BACKGROUND: Pain management after open hysterectomy has been investigated for years. Owing to the effect of significant analgesic, gabapentin was often administrated for pre-emptive analgesia. However, the relationship between gabapentin and postoperative pain after open hysterectomy is still controversial. This meta-analysis was applied to assess the efficacy of pre-emptive use of gabapentin in open hysterectomy. METHODS: This meta-analysis of randomized controlled trials (RCTs) was performed to compare the use of gabapentin with placebo in open hysterectomy regarding (1) the mean difference (MD) of postoperative opioid requirements; (2) the changes of visual analogue scale (VAS) scores in two groups; and (3) incidence rate of adverse effects...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802093/clinical-aspects-of-opium-adulterated-with-lead-in-iran-a-review
#16
Samira Alinejad, Jan Aaseth, Mohammad Abdollahi, Hossein Hassanian-Moghaddam, Omid Mehrpour
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users...
August 12, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28800186/ameliorative-response-to-detoxification-psychotherapy-and-medical-management-in-patients-maintained-on-opioids-for-pain
#17
Molly Belkin, Howard Stephen Reinheimer, Jordan Levy, Brian Johnson
BACKGROUND AND OBJECTIVES: The prevalence of opioid-induced hyperalgesia (OIH) among patients maintained on opioids for chronic non-malignant pain has not been estimated. As a contribution toward establishing its prevalence, we report a case series of opioid maintained patients whose pain tolerance was measured by the cold pressor test at baseline. METHODS: A case series of 117 patients who had undergone detoxification was reviewed retrospectively. Most patients (n = 108) and selected non-addicted support persons who accompanied them (controls; n = 37) had cold pressor time (CPT) assessments at baseline...
August 11, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28796696/opioid-prescription-and-usage-in-adolescents-undergoing-orthopaedic-surgery-in-the-united-states-a-systematic-review
#18
Erin A Dautremont, Edward Ebramzadeh, Jennifer J Beck, Richard E Bowen, Sophia N Sangiorgio
BACKGROUND: The proper use of opioid analgesia for postoperative pain management is controversial. While opioids are considered the standard of care for multimodal postoperative pain modulation in the United States, there is a lack of established protocols for prescribing opioids in adolescents undergoing outpatient orthopaedic surgery. The objective of this review was to identify and report on current literature on opioid prescription for pain management in adolescents undergoing all procedures, as well as in adults undergoing outpatient orthopaedic surgery...
August 8, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28794799/recommendations-for-action-a-community-meeting-in-preparation-for-a-mass-casualty-opioid-overdose-event-in-southeastern-ontario
#19
Kieran Michael Moore, Nicholas Papadomanolakis-Pakis, Adrienne Hansen-Taugher, Tianxiu H Guan, Brian Schwartz, Paula Stewart, Pamela Leece, Richard Bochenek
Given the steady rise of overdose morbidity and mortality in North America, and increasing frequency of sudden clusters of non-fatal and fatal overdoses in other jurisdictions, regional preparedness plans to respond effectively to clusters of overdoses may reduce the impact of such events on the population. On the 27th of February 2017 in Kingston, Ontario, KFL&A Public Health, in collaboration with public health partners, hosted a full-day workshop involving table-top exercises and discussions for service partners on how to prepare for, respond to, and manage a mass-casualty event secondary to opioid overdose in Southeastern Ontario...
2017: BMC Proceedings
https://www.readbyqxmd.com/read/28793780/iatrogenic-opioid-withdrawal-in-critically-ill-patients-a-review-of-assessment-tools-and-management
#20
Ada W Chiu, Sofia Contreras, Sangeeta Mehta, Jennifer Korman, Marc M Perreault, David R Williamson, Lisa D Burry
OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management...
August 1, 2017: Annals of Pharmacotherapy
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