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opioid pain

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https://www.readbyqxmd.com/read/28101968/defined-daily-doses-ddd-do-not-accurately-reflect-opioid-doses-used-in-contemporary-chronic-pain-treatment
#1
Suzanne Nielsen, Natasa Gisev, Raimondo Bruno, Wayne Hall, Milton Cohen, Briony Larance, Gabrielle Campbell, Marian Shanahan, Fiona Blyth, Nicholas Lintzeris, Sallie Pearson, Richard Mattick, Louisa Degenhardt
OBJECTIVE: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. DESIGN: Descriptive, cross-sectional study, utilising a 7-day medication diary. SETTING: Community-based treatment settings, Australia. SUBJECTS: A sample of 1101 people prescribed opioids for chronic non-cancer pain. METHODS: Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week...
January 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28100528/higher-risk-of-opioid-induced-respiratory-depression-in-children-with-neurodevelopmental-disability-a-retrospective-cohort-study-of-12%C3%A2-904-patients
#2
M A Jay, B M Thomas, R Nandi, R F Howard
BACKGROUND: Children with neurodevelopmental disabilities may be at risk of opioid-induced respiratory depression. We aimed to quantify the risks and effectiveness of morphine nurse-controlled analgesia (morphine-NCA) for postoperative pain in children with neurodevelopmental disabilities. METHODS: We carried out a retrospective cohort study of 12 904 children who received postoperative i.v. morphine-NCA. Subjects were divided into a neurodevelopmental disability group and a control group...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#3
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#4
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#5
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#6
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28097228/kappa-opioid-receptor-signaling-protects-cartilage-tissue-against-posttraumatic-degeneration
#7
Ling Wu, Shu Zhang, Ruzanna Shkhyan, Siyoung Lee, Francesca Gullo, Claire D Eliasberg, Frank A Petrigliano, Kai Ba, Jing Wang, Yunfeng Lin, Denis Evseenko
Osteoarthritis is the most common form of arthritis, and pain relief with opioid-like drugs is a commonly used therapeutic for osteoarthritic patients. Recent studies published by our group showed that the kappa opioid receptor (KOR) is highly expressed during human development in joint-forming cells. However, the precise role of this receptor in the skeletal system remains elusive. The main aim of the current study was to investigate the role of KOR signaling in synovial and cartilaginous tissues in pathological conditions...
January 12, 2017: JCI Insight
https://www.readbyqxmd.com/read/28096580/randomized-double-blind-comparison-of-remifentanil-and-alfentanil-in-patients-undergoing-laparoscopic-cholecystectomy-using-total-intravenous-anesthesia
#8
José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28093132/controlled-release-oxycodone-improves-pain-management-after-uterine-artery-embolisation-for-symptomatic-fibroids
#9
G M G Freire, R N Cavalcante, J M Motta-Leal-Filho, M Messina, F L Galastri, B B Affonso, R D Rocha, F Nasser
AIM: To evaluate if pre- and post-procedure administration of controlled-release oxycodone (CRO) in combination with standard analgesia improves pain control and decreases the amount of required post-procedure opioids in uterine fibroid embolisation (UFE). MATERIALS AND METHODS: Between January 2009 and March 2010, 60 consecutive women were prospectively randomised in two groups for UFE: the control group, in which 30 patients underwent the standard anaesthetic procedure and the CRO group, in which 30 patients underwent the standard anaesthetic procedure with the addition of CRO...
January 13, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28093054/impact-of-psychological-stress-on-pain-perception-in-an-animal-model-of-endometriosis
#10
Siomara Hernandez, Myrella L Cruz, Inevy I Seguinot, Annelyn Torres-Reveron, Caroline B Appleyard
PURPOSE: Pain in patients with endometriosis is considered a significant source of stress but does not always correlate with severity of the condition. We have demonstrated that stress can worsen endometriosis in an animal model. Here, we tested the impact of a psychological stress protocol on pain thresholds and pain receptors. METHODS: Endometriosis was induced in female rats by suturing uterine horn tissue next to the intestinal mesentery. Sham rats had sutures only...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28092666/loss-of-%C3%AE-opioid-receptor-signaling-in-nociceptors-but-not-microglia-abrogates-morphine-tolerance-without-disrupting-analgesia
#11
Gregory Corder, Vivianne L Tawfik, Dong Wang, Elizabeth I Sypek, Sarah A Low, Jasmine R Dickinson, Chaudy Sotoudeh, J David Clark, Ben A Barres, Christopher J Bohlen, Grégory Scherrer
Opioid pain medications have detrimental side effects including analgesic tolerance and opioid-induced hyperalgesia (OIH). Tolerance and OIH counteract opioid analgesia and drive dose escalation. The cell types and receptors on which opioids act to initiate these maladaptive processes remain disputed, which has prevented the development of therapies to maximize and sustain opioid analgesic efficacy. We found that μ opioid receptors (MORs) expressed by primary afferent nociceptors initiate tolerance and OIH development...
January 16, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28092651/long-lasting-antinociceptive-effects-of-green-light-in-acute-and-chronic-pain-in-rats
#12
Mohab M Ibrahim, Amol Patwardhan, Kerry B Gilbraith, Aubin Moutal, Xiaofang Yang, Lindsey A Chew, Tally Largent-Milnes, T Philip Malan, Todd W Vanderah, Frank Porreca, Rajesh Khanna
Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain...
February 2017: Pain
https://www.readbyqxmd.com/read/28092649/new-onset-depression-following-stable-slow-and-rapid-rate-of-prescription-opioid-dose-escalation
#13
Joanne Salas, Jeffrey F Scherrer, Frank David Schneider, Mark D Sullivan, Kathleen K Bucholz, Thomas Burroughs, Laurel A Copeland, Brian K Ahmedani, Patrick J Lustman
Recent studies suggest that longer durations of opioid use, independent of maximum morphine equivalent dose (MED) achieved, is associated with increased risk of new-onset depression (NOD). Conversely, other studies, not accounting for duration, found that higher MED increased probability of depressive symptoms. To determine whether rate of MED increase is associated with NOD, a retrospective cohort analysis of Veterans Health Administration data (2000-2012) was conducted. Eligible patients were new, chronic (>90 days) opioid users, aged 18 to 80, and without depression diagnoses for 2 years before start of follow-up (n = 7051)...
February 2017: Pain
https://www.readbyqxmd.com/read/28092648/does-brief-chronic-pain-management-education-change-opioid-prescribing-rates-a-pragmatic-trial-in-australian-early-career-general-practitioners
#14
Simon Mark Holliday, Chris Hayes, Adrian J Dunlop, Simon Morgan, Amanda Tapley, Kim M Henderson, Mieke L van Driel, Elizabeth G Holliday, Jean I Ball, Andrew Davey, Neil Allan Spike, Lawrence Andrew McArthur, Parker John Magin
We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls...
February 2017: Pain
https://www.readbyqxmd.com/read/28092646/ex-vivo-nonviral-gene-delivery-of-%C3%AE-opioid-receptor-to-attenuate-cancer-induced-pain
#15
Seiichi Yamano, Chi T Viet, Dongmin Dang, Jisen Dai, Shigeru Hanatani, Tadahiro Takayama, Hironori Kasai, Kentaro Imamura, Ron Campbell, Yi Ye, John C Dolan, William Myung Kwon, Stefan D Schneider, Brian L Schmidt
Virus-mediated gene delivery shows promise for the treatment of chronic pain. However, viral vectors have cytotoxicity. To avoid toxicities and limitations of virus-mediated gene delivery, we developed a novel nonviral hybrid vector: HIV-1 Tat peptide sequence modified with histidine and cysteine residues combined with a cationic lipid. The vector has high transfection efficiency with little cytotoxicity in cancer cell lines including HSC-3 (human tongue squamous cell carcinoma) and exhibits differential expression in HSC-3 (∼45-fold) relative to HGF-1 (human gingival fibroblasts) cells...
February 2017: Pain
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#16
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092326/using-placebos-as-an-opioid-sparing-method-of-pain-management
#17
Carla R Jungquist, Michael L Perlis, Romanth Waghmarae
No abstract text is available yet for this article.
February 2017: Pain
https://www.readbyqxmd.com/read/28092325/persistent-pain-after-motor-vehicle-collision-comparative-effectiveness-of-opioids-vs-nonsteroidal-antiinflammatory-drugs-prescribed-from-the-emergency-department-a-propensity-matched-analysis
#18
Francesca L Beaudoin, Roee Gutman, Roland C Merchant, Melissa A Clark, Robert A Swor, Jeffrey S Jones, David C Lee, David A Peak, Robert M Domeier, Niels K Rathlev, Samuel A McLean
Each year millions of Americans present to the emergency department (ED) for care after a motor vehicle collision (MVC); the majority (>90%) are discharged to home after evaluation. Acute musculoskeletal pain is the norm in this population, and such patients are typically discharged to home with prescriptions for oral opioid analgesics or nonsteroidal antiinflammatory drugs (NSAIDs). The influence of acute pain management on subsequent pain outcomes in this common ED population is unknown. We evaluated the effect of opioid analgesics vs NSAIDs initiated from the ED on the presence of moderate to severe musculoskeletal pain and ongoing opioid use at 6 weeks in a large cohort of adult ED patients presenting to the ED after MVC (n = 948)...
February 2017: Pain
https://www.readbyqxmd.com/read/28092324/long-term-use-of-opioids-for-nonmalignant-pain-among-community-dwelling-persons-with-and-without-alzheimer-disease-in-finland-a-nationwide-register-based-study
#19
Aleksi Hamina, Heidi Taipale, Antti Tanskanen, Anna-Maija Tolppanen, Niina Karttunen, Liisa Pylkkänen, Jari Tiihonen, Sirpa Hartikainen
Persons with Alzheimer disease (AD) commonly present with chronic nonmalignant pain, but long-term use of opioids among this population has not been studied previously. Our aim was to investigate the prevalence of long-term (≥180 days) use of opioids for nonmalignant pain and associated factors among community-dwelling persons with AD and to compare the prevalence with a matched cohort without AD. The Medication use and Alzheimer's disease (MEDALZ) cohort was used for this study, comprising all community-dwelling persons diagnosed with AD in Finland during 2005 to 2011 and their matched comparison persons without AD...
February 2017: Pain
https://www.readbyqxmd.com/read/28092323/brain-substrates-of-reward-processing-and-the-%C3%AE-opioid-receptor-a-pathway-into-pain
#20
Frauke Nees, Susanne Becker, Sabina Millenet, Tobias Banaschewski, Luise Poustka, Arun Bokde, Uli Bromberg, Christian Büchel, Patricia J Conrod, Sylvane Desrivières, Vincent Frouin, Jürgen Gallinat, Hugh Garavan, Andreas Heinz, Bernd Ittermann, Jean-Luc Martinot, Dimitri Papadopoulos Orfanos, Tomáš Paus, Michael N Smolka, Henrik Walter, Rob Whelan, Gunter Schumann, Herta Flor
The processing of reward and reinforcement learning seems to be important determinants of pain chronicity. However, reward processing is already altered early in life and if this is related to the development of pain symptoms later on is not known. The aim of this study was first to examine whether behavioural and brain-related indicators of reward processing at the age of 14 to 15 years are significant predictors of pain complaints 2 years later, at 16 to 17 years. Second, we investigated the contribution of genetic variations in the opioidergic system, which is linked to the processing of both, reward and pain, to this prediction...
February 2017: Pain
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