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https://www.readbyqxmd.com/read/29244992/oral-morphine-use-in-south-india-a-population-based-study
#1
M R Rajagopal, Safiya Karim, Christopher M Booth
Purpose Access to opioids for pain control is recognized as an urgent issue in low- and middle-income countries. Here we report temporal and regional trends in morphine use in Kerala, India. Methods Oral morphine use data for the State of Kerala (2012 to 2015) was used to describe temporal trends, regional variation, and provider characteristics. Total morphine use was calculated for each district of Kerala to derive an annual per capita use rate (milligrams per capita). Each provider was classified as government, private, nongovernment organization (NGO), or NGO partnership...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29244102/association-of-opioid-usage-with-spinal-cord-stimulation-outcomes
#2
Ashwini D Sharan, Jonathan Riley, Steven Falowski, Jason E Pope, Allison T Connolly, Edward Karst, Nirav Dalal, David A Provenzano
Study Design: Observational study using insurance claims. Objective: To quantify opioid usage leading up to spinal cord stimulation (SCS) and the potential impact on outcomes of SCS. Setting: SCS is an interventional therapy that often follows opioid usage in the care continuum for chronic pain. Methods: This study identified SCS patients using the Truven Health MarketScan databases from January 2010 to December 2014...
December 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29243848/analgesic-efficacy-of-preoperative-dexketoprofen-trometamol-a-systematic-review-and-meta-analysis
#3
Vicente Esparza-Villalpando, Amaury Pozos-Guillén, David Masuoka-Ito, César Gaitán-Fonseca, Daniel Chavarría-Bolaños
Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017...
December 15, 2017: Drug Development Research
https://www.readbyqxmd.com/read/29243218/no-pain-no-gain-balancing-central-vs-peripheral-benefits-of-analgesics-in-the-age-of-the-opioid-crisis
#4
Hemal H Patel, David M Roth
No abstract text is available yet for this article.
December 15, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29243034/application-of-pyridostigmine-in-pediatric-gastrointestinal-motility-disorders-a-case-series
#5
Mhd Louai Manini, Michael Camilleri, Rayna Grothe, Carlo Di Lorenzo
BACKGROUND: Gastrointestinal (GI) motility disorders are common in children. Treatment is challenging with limited medical and surgical options. Pyridostigmine, an acetyl cholinesterase inhibitor, increases acetylcholine at the neuromuscular junction promoting intestinal contractions. Little is known about the role and dosing of pyridostigmine in pediatric GI motility disorders. METHODS: We present a case series of children with GI dysmotility managed with oral pyridostigmine...
December 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29242972/perioperative-pain-after-robot-assisted-versus-laparoscopic-rectal-resection
#6
Rikke Tolstrup, Jonas Amstrup Funder, Liselotte Lundbech, Niels Thomassen, Lene Hjerrild Iversen
BACKGROUND: In order to improve the surgical treatment of rectal cancer, robot-assisted laparoscopy has been introduced. The robot has gained widespread use; however, the scientific basis for treatment of rectal cancer is still unclear. The aim of this study was to investigate whether robot-assisted laparoscopic rectal resection cause less perioperative pain than standard laparoscopic resection measured by the numerical rating scale (NRS score) as well as morphine consumption. METHODS: Fifty-one patients were randomized to either laparoscopic or robot-assisted rectal resection at the Department of Surgery at Aarhus University Hospital in Denmark...
December 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29242658/quadratus-lumborum-block-for-post-operative-pain-relief-in-patient-with-prune-belly-syndrome
#7
Chitra Garg, Sangeeta Khanna, Yatin Mehta
Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10-T12 segments, providing only partial pain relief. The new quadratus lumborum (QL) block has the advantage of providing wider sensory block from T6 to L1 and thus has an evolving role in opioid-free anaesthesia. Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29241834/efficacy-and-safety-of-oral-and-transdermal-opioid-analgesics-for-musculoskeletal-pain-in-older-adults-a-systematic-review-of-randomized-placebo-controlled-trials
#8
REVIEW
Rodrigo Z Megale, Leticia A Deveza, Fiona M Blyth, Vasi Naganathan, Paulo H Ferreira, Andrew J McLachlan, Manuela L Ferreira
This systematic review with meta-analysis was performed to evaluate the efficacy and safety of using opioid analgesics in older adults with musculoskeletal pain. We searched Cochrane Library, MEDLINE, EMBASE, Web of Science, AMED, CINAHL and LILACS for randomized controlled trial with mean population age of 60 years or older, comparing the efficacy and safety of opioid analgesics with placebo for musculoskeletal pain conditions. Reviewers extracted data, assessed risk of bias and evaluated the quality of evidence using the GRADE approach...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29241501/cyp2d6-drug-gene-and-drug-drug-gene-interactions-among-patients-prescribed-pharmacogenetically-actionable-opioids
#9
Mitchell R Knisely, Janet S Carpenter, Claire Burke Draucker, Todd Skaar, Marion E Broome, Ann M Holmes, Diane Von Ah
PURPOSE: When codeine and tramadol are used for pain management, it is imperative that nurses are able to assess for potential drug-gene and drug-drug-gene interactions that could adversely impact drug metabolism and ultimately pain relief. Both drugs are metabolized through the CYP2D6 metabolic pathway which can be affected by medications as well the patient's own pharmacogenotype. The purpose of this brief report is to identify drug-gene and drug-drug-gene interactions in 30 adult patients prescribed codeine or tramadol for pain...
December 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#10
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29240318/ketamine-in-the-treatment-of-acute-pain
#11
Elina Brinck, Vesa Kontinen
Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29240048/why-patients-are-afraid-of-opioid-analgesics-study-on-opioid-perception-in-patients-treated-for-chronic-pain
#12
Michał Graczyk, Alina Borkowska, Małgorzata Krajnik
INTRODUCTION    Opiophobia is deemed one of the key barriers in effective pain management.  OBJECTIVES    The study aimed to assess overall perception of opioids in cancer patients suffering from and treated for chronic pain, as well as determine the nature of their most common, related fears.  PATIENTS AND METHODS    The study comprised 100 palliative care patients who suffered from chronic cancer or non-cancer pain. Initially, they had to complete a survey exploring their knowledge on analgesics and potential fear of using opioids...
December 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29239974/additive-and-subadditive-antiallodynic-interactions-between-%C3%AE-opioid-agonists-and-n-methyl-d-aspartate-antagonists-in-male-rhesus-monkeys
#13
Jeremy C Cornelissen, Floyd F Steele, Kenner C Rice, Katherine L Nicholson, Matthew L Banks
μ-Opioid agonists are clinically effective analgesics, but also produce undesirable effects such as sedation and abuse potential that limit their clinical utility. Glutamatergic systems also modulate nociception and N-methyl D-aspartate (NMDA) receptor antagonists have been proposed as one useful adjunct to enhance the therapeutic effects and/or attenuate the undesirable effects of μ-opioid agonists. Whether NMDA antagonists enhance the antiallodynic effects of μ-agonists in preclinical models of thermal hypersensitivity (i...
December 12, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/29239947/treatment-of-chronic-pain-with-various-buprenorphine-formulations-a-systematic-review-of-clinical-studies
#14
Rohit Aiyer, Amitabh Gulati, Semih Gungor, Anuj Bhatia, Neel Mehta
Clinical studies demonstrate that buprenorphine is a pharmacologic agent that can be used for the treatment of various types of painful conditions. This study investigated the efficacy of 5 different types of buprenorphine formulations in the chronic pain population. The literature was reviewed on PubMed/MEDLINE, EMBASE, Cochrane Database, clinicaltrials.gov, and PROSPERO that dated from inception until June 30, 2017. Using the population, intervention, comparator, and outcomes method, 25 randomized controlled trials were reviewed involving 5 buprenorphine formulations in patients with chronic pain: intravenous buprenorphine, sublingual buprenorphine, sublingual buprenorphine/naloxone, buccal buprenorphine, and transdermal buprenorphine, with comparators consisting of opioid analgesics or placebo...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29239621/a-qualitative-analysis-of-gabapentin-misuse-and-diversion-among-people-who-use-drugs-in-appalachian-kentucky
#15
Rachel Vickers Smith, Elaine M Boland, April M Young, Michelle R Lofwall, Alexa Quiroz, Michele Staton, Jennifer R Havens
Gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary. Gabapentin has been linked with impaired driving and opioid use, highlighting the need to more fully understand its risk profile. Thirty-three individuals reporting recent nonmedical use of gabapentin were recruited from two ongoing longitudinal studies of drug users in Appalachian Kentucky to participate in focus groups. Four sessions were held (two in the community and two in jail settings), during which participants responded to questions regarding their personal experiences with gabapentin misuse...
December 14, 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/29239152/the-safety-and-efficiency-of-a-fast-track-protocol-for-sleeve-gastrectomy-a-team-approach
#16
Sebastiaan J Vreeswijk, Pim W van Rutte, Simon W Nienhuijs, R Arthur Bouwman, J Frans Smulders, Marc P Buise
BACKGROUND: Increasing numbers of morbid obese patients has led to increased numbers of bariatric procedures. Fast-track protocols are being developed to enhance the available resources, while maintaining a safe procedure. Reported results on safety merely apply to a mixed bariatric population. The objective was to evaluate safety and efficiency of the fast-track principles in patients undergoing sleeve gastrectomy. METHODS: Retrospective observational study including patients undergoing primary sleeve gastrectomy at the Obesity Centre of the Catharina Hospital Eindhoven, the Netherlands...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29238824/effect-of-perioperative-gabapentin-on-postoperative-pain-resolution-and-opioid-cessation-in-a-mixed-surgical-cohort-a-randomized-clinical-trial
#17
Jennifer Hah, Sean C Mackey, Peter Schmidt, Rebecca McCue, Keith Humphreys, Jodie Trafton, Bradley Efron, Debra Clay, Yasamin Sharifzadeh, Gabriela Ruchelli, Stuart Goodman, James Huddleston, William J Maloney, Frederick M Dirbas, Joseph Shrager, John Costouros, Catherine Curtin, Ian Carroll
Importance: Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. Objective: To determine the effect of perioperative gabapentin on remote postoperative time to pain resolution and opioid cessation. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of perioperative gabapentin was conducted at a single-center, tertiary referral teaching hospital...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29237039/development-of-a-brief-version-of-the-current-opioid-misuse-measure-comm-the-comm-9
#18
Stacey A McCaffrey, Ryan A Black, Albert J Villapiano, Robert N Jamison, Stephen F Butler
Objective: The Current Opioid Misuse Measure (COMM) is a commonly used self-report instrument to identify and monitor aberrant opioid-related behavior in chronic pain patients on opioid therapy. However, the length of the COMM may limit its clinical utility. Additionally, this paper-and-pencil screener requires hand scoring, which increases paperwork and staff burden. Therefore, the current study presents development of the "COMM-9," a brief electronically administered form of the COMM...
December 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29236967/postoperative-analgesia-after-pulmonary-resection-with-a-focus-on-video-assisted-thoracoscopic-surgery
#19
Marzia Umari, Valentina Carpanese, Valeria Moro, Gaia Baldo, Stefano Addesa, Enrico Lena, Stefano Lena, Umberto Lucangelo
Video-assisted thoracoscopic surgery is a widespread technique that has been linked to improved postoperative respiratory function, reduced hospital length of stay and a higher level of tolerability for the patients. Acute postoperative pain is of considerable significance, and the late development of neuropathic pain syndrome is also an issue. As anaesthesiologists, we have investigated the available evidence to optimize postoperative pain management. An opioid-sparing multimodal approach is highly recommended...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29234960/a-new-postoperative-pain-management-intravenous-acetaminophen-acelio%C3%A2-leads-to-enhanced-recovery-after-esophagectomy-a-propensity-score-matched-analysis
#20
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Harushi Udagawa
PURPOSES: To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared. RESULTS: Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0...
December 12, 2017: Surgery Today
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