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Opioid dose ranges

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https://www.readbyqxmd.com/read/29440926/local-anesthetics-for-brain-tumor-resection-current-perspectives
#1
REVIEW
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29416859/applying-realistic-medicine-to-intrathecal-opioid-utilisation-in-scotland-do-we-have-a-standardised-approach
#2
Robert Hart, Gordon Burns, Susan Smith
Intrathecal opioids (ITOs) are commonly administered as part of a multimodal anaesthetic strategy for a variety of surgical procedures. The evolution of laparoscopic surgical techniques has seen the popularity of ITOs increase as they are effective, well tolerated and lack the cardiovascular side effects associated with epidural infusions. The risk of delayed respiratory depression remains a concern; therefore, high-quality post-operative monitoring is vital. The evidence regarding the practicalities of ITO administration such as opioid dose, type, side effect prevalence and ideal post-operative care arrangements are sparse...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29412458/oliceridine-trv130-a-novel-g-protein-biased-ligand-at-the-%C3%AE-opioid-receptor-demonstrates-a-predictable-relationship-between-plasma-concentrations-and-pain-relief-i-development-of-a-pharmacokinetic-pharmacodynamic-model
#3
Michael J Fossler, Brian M Sadler, Colm Farrell, David A Burt, Maria Pitsiu, Franck Skobieranda, David G Soergel
Conventional opioids bind to μ-opioid receptors and activate 2 downstream signaling pathways: G-protein coupling, linked to analgesia, and β-arrestin recruitment, linked to opioid-related adverse effects and limiting efficacy. Oliceridine (TRV130) is a novel G protein-biased ligand at the μ-opioid receptor that differentially activates G-protein coupling while mitigating β-arrestin recruitment. Using data derived from both phase 1 studies in healthy volunteers as well as data from a phase 2 study examining the efficacy of oliceridine for the treatment of postbunionectomy pain, we have developed a population pharmacokinetic/pharmacodynamic model linking the pharmacokinetics of oliceridine to its effect on pain, as measured by the Numeric Pain Rating Scale score...
February 7, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29402712/patients-at-risk-preoperative-opioid-use-affects-opioid-prescribing-refills-and-outcomes-after-total-knee-arthroplasty
#4
Nicholas M Hernandez, Joshua A Parry, Tad M Mabry, Michael J Taunton
BACKGROUND: The purpose of this study was to evaluate the effect of preoperative opioid use on opioid prescriptions, refills, and clinical outcomes after total knee arthroplasty (TKA). METHODS: A retrospective review identified 53 patients on preoperative opioids who were matched 1:2 to 106 opioid-naive patients undergoing primary TKA with at least 2-year follow-up. Opioid refills, Knee Society Score (preoperative and follow-up), morphine equivalent dose (MED) prescribed, and persistent opioid use were compared between groups...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29392214/the-opioid-epidemic-and-national-guidelines-for-opioid-therapy-for-chronic-noncancer-pain-a-perspective-from-different-continents
#5
Winfried Häuser, Stephan Schug, Andrea D Furlan
Introduction: A marked rise in opioid prescriptions for patients with chronic noncancer pain (CNCP) with a parallel increase in opioid abuse/misuse, and resulting deaths was noted in the Unites states in the past decade (opioid epidemic). In response, the US Center of Diseases Control (CDC) developed a guideline for prescribing of opioids for patients with CNCP. Objectives: To assess (1) if there is an opioid epidemic in Australia, Canada, and Germany (2) to compare Australian, Canadian, German, and Center of Diseases Control guidelines recommendations for long-term opioid therapy for CNCP...
May 2017: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29349283/is-self-rated-health-in-adolescence-a-predictor-of-prescribed-medication-in-adulthood-findings-from-the-nord-tr%C3%A3-ndelag-health-study-and-the-norwegian-prescription-database
#6
Tina Lokke Vie, Karl Ove Hufthammer, Turid Lingaas Holmen, Eivind Meland, Hans Johan Breidablik
Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years' prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16...
April 2018: SSM—Population Health
https://www.readbyqxmd.com/read/29347984/the-effects-of-state-rules-on-opioid-prescribing-in-indiana
#7
Morhaf Al Achkar, Shaun Grannis, Debra Revere, Palmer MacKie, Meredith Howard, Sumedha Gupta
BACKGROUND: Prescription opioids have been linked to over half of the 28,000 opioid overdose deaths in 2014. High rates of prescription opioid non-medical use have continued despite nearly all states implementing large-scale prescription drug monitoring programs (PDMP), which points to the need to examine the impact of state PDMP's on curbing inappropriate opioid prescribing. In the short-term, PDMPs have been associated with short-term prescribing declines. Yet little is known about how such policies differentially impact patient subgroups or are interpreted by prescribing providers...
January 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29346228/analgesia-of-combined-femoral-triangle-and-obturator-nerve-blockade-is-superior-to-local-infiltration-analgesia-after-total-knee-arthroplasty-with-high-dose-intravenous-dexamethasone
#8
Charlotte Runge, Jan Mick Jensen, Louise Clemmesen, Henriette Bach Knudsen, Carsten Holm, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: High-dose intravenous dexamethasone reduces the postoperative opioid requirement and is often included in the multimodal analgesia strategy after total knee arthroplasty (TKA). Combined obturator nerve and femoral triangle blockade (OFB) reduces the opioid consumption and pain after TKA better than local infiltration analgesia (LIA). The question is whether preoperative high-dose intravenous dexamethasone would cancel out the superior analgesic effect of OFB compared with LIA...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29334921/a-pilot-feasibility-randomised-controlled-trial-of-an-adjunct-brief-social-network-intervention-in-opiate-substitution-treatment-services
#9
Ed Day, Alex Copello, Jennifer L Seddon, Marilyn Christie, Deborah Bamber, Charlotte Powell, Carmel Bennett, Shabana Akhtar, Sanju George, Andrew Ball, Emma Frew, Ilias Goranitis, Nick Freemantle
BACKGROUND: Approximately 3% of people receiving opioid substitution therapy (OST) in the UK manage to achieve abstinence from prescribed and illicit drugs within three years of commencing treatment. Involvement of families and wider social networks in supporting psychological treatment may be an effective strategy in facilitating recovery, and this pilot study aimed to evaluate the impact of a social network-focused intervention for patients receiving OST. METHODS: A two-site, open feasibility trial randomised patients receiving OST for at least 12 months but still reporting illicit opiate use in the past 28 days to one of three treatments: 1) treatment as usual (TAU), 2) Brief Social Behaviour and Network Therapy (B-SBNT) + TAU, or 3) Personal Goal Setting (PGS) + TAU...
January 15, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29303393/high-risk-prescribing-to-medicaid-enrollees-receiving-opioid-analgesics-individual-and-county-level-factors
#10
Sara E Heins, Mark J Sorbero, Christopher M Jones, Andrew W Dick, Bradley D Stein
BACKGROUND: Prescription opioid overdoses have increased dramatically in recent years, with the highest rates among Medicaid enrollees. High-risk prescribing includes practices associated with overdoses and a range of additional opioid-related problems. OBJECTIVES: To identify individual- and county-level factors associated with high-risk prescribing among Medicaid enrollees receiving opioids. METHODS: In a four-states, cross-sectional claims data study, Medicaid enrollees 18-64 years old with a new opioid analgesic treatment episode 2007-2009 were identified...
January 5, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29297827/alfaxalone-anesthesia-in-the-bengalese-finch-lonchura-domestica
#11
Kathryn L Perrin, Jesper B Nielsen, Anders F Thomsen, Mads F Bertelsen
The objective of this study was to evaluate the use of alfaxalone in a small passerine species. A dose-response trial was conducted whereby 10, 30, and 50 mg/kg alfaxalone was administered subcutaneously (SC) to 10 Bengalese finches ( Lonchura domestica) in a randomized complete crossover study design. Subsequently, a similar protocol was used to compare 30 mg/kg alfaxalone alone or combined with either 0.7 mg/kg midazolam or 1 mg/kg butorphanol SC. Induction and recovery times were recorded and depth of anesthesia monitored at 5-min intervals throughout each procedure...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29274880/cb1-cannabinoid-receptor-agonist-mouse-vd-hemopressin-%C3%AE-produced-supraspinal-analgesic-activity-in-the-preclinical-models-of-pain
#12
Ting Zheng, Run Zhang, Ting Zhang, Meng-Na Zhang, Biao Xu, Jing-Jing Song, Ning Li, Hong-Hai Tang, Pei Wang, Rui Wang, Quan Fang
Mouse VD-hemopressin(α) (VD-Hpα) is an undecapeptide that selectively activates CB1 cannabinoid receptor in in vitro functional tests, and exerts CB1-mediated central antinociception in the mouse tail-flick assay. The aim of the present study was to further investigate the analgesic properties of supraspinal mouse VD-Hpα in a range of preclinical pain models. Our results indicated that the classical cannabinoid agonist WIN 55,212-2 produced supraspinal analgesia in preclinical pain models, which was selectively antagonized by the CB1 antagonist/inverse agonist AM251, but not by the CB2 antagonist AM630...
December 21, 2017: Brain Research
https://www.readbyqxmd.com/read/29258584/lymphocyte-opioid-receptors-as-innovative-biomarkers-of-osteoarthritic-pain-for-the-assessment-and-risk-management-of-opioid-tailored-therapy-before-hip-surgery-to-prevent-chronic-pain-and-opioid-tolerance-addiction-development-opmarkart-opioids-markers-arthroprosthesis
#13
Valentina Malafoglia, Monica Celi, Carolina Muscoli, Sara Ilari, Filomena Lauro, Luigino Antonio Giancotti, Chiara Morabito, Maurizio Feola, Umberto Tarantino, William Raffaeli
BACKGROUND: The incidence of post-surgical chronic pain ranges between 20% and 40% in Europe. Osteoarthritis pain after prosthesis implantation is one of the most severe secondary syndromes, depending not only on surgery but also on organic changes before and after joints replacement. No data are available about risk factors. An excessive inflammatory response plays a central role but a best therapy is not defined yet. It is not clear whether opioid administration could influence post-surgical pain and lead to tolerance or addiction...
December 19, 2017: Trials
https://www.readbyqxmd.com/read/29245214/the-efficiency-and-safety-of-local-liposomal-bupivacaine-infiltration-for-pain-control-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#14
REVIEW
Xin Zhang, Qing Yang, Zhi Zhang
OBJECTIVE: This meta-analysis aimed to compare the efficiency and safety of local liposomal bupivacaine infiltration and traditional cocktail analgesia for pain management in total hip arthroplasty (THA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. INCLUSION CRITERIA: Participants: patients planned for a THA with a diagnosis of hip osteoarthritis. INTERVENTIONS: liposomal bupivacaine was administrated in the experimental groups for pain control...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243848/analgesic-efficacy-of-preoperative-dexketoprofen-trometamol-a-systematic-review-and-meta-analysis
#15
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/29243034/application-of-pyridostigmine-in-pediatric-gastrointestinal-motility-disorders-a-case-series
#16
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/29222126/autoimmune-crmp5-neuropathy-phenotype-and-outcome-defined-from-105-cases
#17
Divyanshu Dubey, Vanda A Lennon, Avi Gadoth, Sean J Pittock, Eoin P Flanagan, John E Schmeling, Andrew McKeon, Christopher J Klein
OBJECTIVE: To establish the phenotype and clinical outcomes of collapsin response-mediator protein-5 (CRMP5) autoimmune neuropathy in comparison with anti-neuronal nuclear antibody type 1 (ANNA1)-immunoglobulin G (IgG) neuropathy. METHODS: Patients with CRMP5-IgG and/or ANNA1-IgGs were identified in our service-line testing, and medical records were reviewed. RESULTS: One hundred five patients with CRMP5-IgG neuropathy (88% smokers; 69% having cancer, most commonly small cell lung cancer [75%]) were identified and compared to 51 patients with ANNA1-IgG neuropathy, 27 with coexisting CRMP5-IgG...
January 9, 2018: Neurology
https://www.readbyqxmd.com/read/29208477/impact-of-opioid-therapy-on-sleep-and-respiratory-patterns-in-adults-with-advanced-cancer-receiving-palliative-care
#18
Phillip Good, Ross Pinkerton, Simon Bowler, Justin Craig, Janet Hardy
CONTEXT: In advanced cancer, abnormal sleep patterns may contribute to poor quality of life but the impact of opioid related sleep disorders has not been explored in detail in these patients. OBJECTIVE: To document sleep and respiratory patterns in patients with cancer, receiving a range of opioids, determine factors that contribute to severity of central or obstructive apnoea and to what extent these contribute to sleep disturbance. METHODS: Adults with advanced cancer admitted to a palliative care service underwent a sleep analysis by an unattended polysomnograph...
December 2, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29189368/opioid-prescribing-for-the-treatment-of-acute-pain-in-children-on-hospital-discharge
#19
Constance L Monitto, Aaron Hsu, Shuna Gao, Paul T Vozzo, Paul S Park, Deborah Roter, Gayane Yenokyan, Elizabeth D White, Deepa Kattail, Amy E Edgeworth, Kelly J Vasquenza, Sara E Atwater, Joanne E Shay, Jessica A George, Barbara A Vickers, Sabine Kost-Byerly, Benjamin H Lee, Myron Yaster
BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29184448/older-adults-and-high-risk-medication-administration-in-the-emergency-department
#20
Mitchell Kim, Steven H Mitchell, Medley Gatewood, Katherine A Bennett, Paul R Sutton, Carol A Crawford, Itay Bentov, Mamatha Damodarasamy, Stephen J Kaplan, May J Reed
Background: Older adults are susceptible to adverse effects from opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines (BZDs). We investigated factors associated with the administration of elevated doses of these medications of interest to older adults (≥65 years old) in the emergency department (ED). Patients and methods: ED records were queried for the administration of medications of interest to older adults at two academic medical center EDs over a 6-month period...
2017: Drug, Healthcare and Patient Safety
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