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Opioid dose ranges

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https://www.readbyqxmd.com/read/29922156/ibogaine-detoxification-transitions-opioid-and-cocaine-abusers-between-dependence-and-abstinence-clinical-observations-and-treatment-outcomes
#1
Deborah C Mash, Linda Duque, Bryan Page, Kathleen Allen-Ferdinand
Ibogaine may be effective for transitioning opioid and cocaine dependent individuals to sobriety. American and European self-help groups provided public testimonials that ibogaine alleviated drug craving and opioid withdrawal symptoms after only a single dose administration. Preclinical studies in animal models of addiction have provided proof-of-concept evidence in support of these claims. However, the purported therapeutic benefits of ibogaine are based on anecdotal reports from a small series of case reports that used retrospective recruitment procedures...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29915993/fentanyl-treatment-for-end-of-life-dyspnoea-relief-in-advanced-cancer-patients
#2
Miguel Angel Benítez-Rosario, Inmaculada Rosa-González, Enrique González-Dávila, Emilio Sanz
PURPOSE: We assessed the effects of subcutaneous-endovenous fentanyl on dyspnoea in a cohort of advanced cancer patients. METHODS: We performed a retrospective study in a cohort of advanced cancer patients with dyspnoea at rest who received subcutaneous or intravenous fentanyl. Patients with no shortness of breath at rest or at minimal exertion, no rescue doses per 24 h, were deemed to be responders to fentanyl. The period of assessment was 6 days from the beginning of fentanyl treatment...
June 18, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29914002/pain-sensitivity-and-experimentally-induced-sensitisation-in-red-haired-females
#3
Trine Andresen, Dagmar Lunden, Asbjørn M Drewes, Lars Arendt-Nielsen
Introduction and aim Pain sensitivity has been linked to the melanocortin-1 receptor (MC1R) gene. A mutation in MC1R can result in pale skin and red hair in humans and may modulate pain responses in general. Human studies have shown that women with non-functional MC1R's were sensitive to experimental induced cold and heat pain. A study demonstrated that females with red hair required higher dose of anesthesia than females with dark hair to experience analgesia to electrical stimulation. Moreover, women expressing non-functional MC1Rs display greater analgesia from opioid analgesia...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913764/a-randomized-study-comparing-plasma-concentration-of-ropivacaine-after-local-infiltration-analgesia-and-femoral-block-in-primary-total-knee-arthroplasty
#4
Fatin Affas, Carl-Olav Stiller, Eva-Britt Nygårds, Niclas Stephanson, Per Wretenberg, Christina Olofsson
Pain after total knee arthroplasty (TKA) is difficult to control. A recently developed and increasingly popular method for postoperative analgesia following knee and hip arthroplasty is Local Infiltration Analgesia (LIA) with ropivacaine, ketorolac and epinephrine. This method is considered to have certain advantages, which include administration at the site of traumatized tissue, minimal systemic side effects, faster postoperative mobilization, earlier postoperative discharge from hospital and less opioid consumption...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29912070/the-impact-of-massage-and-reading-on-children-s-pain-and-anxiety-after-cardiovascular-surgery-a-pilot-study
#5
Sandra L Staveski, Karen Boulanger, Lee Erman, Li Lin, Christina Almgren, Chloe Journel, Stephen J Roth, Brenda Golianu
OBJECTIVES: The purpose of this pilot study was three-fold: 1) to evaluate the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery, 2) to examine the preliminary results on effects of massage therapy versus standard of care plus three reading visits on postoperative pain and anxiety, and 3) to evaluate preliminary effects of opioid and benzodiazepine exposure in patients receiving massage therapy compared with reading controls...
June 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29911623/characterization-of-complex-chronic-pain-patients
#6
E-B Hysing, T Gordh, R Karlsten, L Smith
Aims Treatment of the most complex chronic pain patients, often not accepted in regular pain management programs, remains a challenge.To beable todesign interventions for these patients we must know what characterize them. The aim of this study was to characterize a subgroup of pain patients, treated in our in-patient rehabilitation programme, organized at the University Hospital in Uppsala, the only tertiary treatment for pain patients in Sweden. Methods The study was approved by the Regional Ethical Review Board in Uppsala (Dnr 2010/182)...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29890864/effect-of-periarticular-morphine-injection-for-total-hip-arthroplasty-a-randomised-double-blind-trial
#7
Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Akio Kobayashi, Hiroaki Nakamura
BACKGROUND: The periarticular multimodal cocktail injection is currently commonly used to treat postoperative pain after total hip arthroplasty (THA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent THA. MATERIALS AND METHODS: This was a prospective, single-centre, randomised controlled trial involving 100 patients scheduled for unilateral THA...
June 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29885995/predictors-of-pain-palliation-after-radiation-therapy-for-painful-tumors-a-prospective-observational-study
#8
Tetsuo Saito, Ryo Toya, Etsushi Tomitaka, Tomohiko Matsuyama, Satoshi Ninomura, Natsuo Oya
PURPOSE: Although radiation therapy (RT) is an important part of treatment for cancer pain, prediction of the patient's pain response remains difficult. We evaluated the characteristics of patients, their tumors, and their pain to identify the predictors of pain palliation after RT for painful tumors. METHODS: Our 3-center prospective observational study included patients scheduled for palliative or curative RT for painful tumors. Brief Pain Inventory data were collected at the start of RT and 1, 2, and 3 months thereafter...
May 4, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29880285/a-multimodal-analgesic-protocol-may-reduce-opioid-use-after-third-molar-surgery-a-pilot-study
#9
Caitlin Magraw, Matthew Pham, Timothy Neal, Barry Kendell, Glenn Reside, Ceib Phillips, Raymond P White
OBJECTIVE: This study was designed to assess the number of opioid doses available to patients from filled prescriptions after adoption, in 2017, of a multimodal analgesic protocol that included opioid prescribing to manage postoperative pain. STUDY DESIGN: Data were retrieved from records of the first 24 patients having third molar surgery in 2017 identified from appointment schedules. Inclusion criteria were American Society of Anesthesiologists risk classification I or II, age 18 to 35 years, and at least 2 lower third molars removed...
May 3, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29847382/intraoperative-methadone-in-same-day-ambulatory-surgery-a-randomized-double-blinded-dose-finding-pilot-study
#10
Helga Komen, L Michael Brunt, Elena Deych, Jane Blood, Evan D Kharasch
BACKGROUND: Approximately 50 million US patients undergo ambulatory surgery annually. Postoperative opioid overprescribing is problematic, yet many patients report inadequate pain relief. In major inpatient surgery, intraoperative single-dose methadone produces better analgesia and reduces opioid use compared with conventional repeated dosing of short-duration opioids. This investigation tested the hypothesis that in same-day ambulatory surgery, intraoperative methadone, compared with short-duration opioids, reduces opioid consumption and pain, and determined an effective intraoperative induction dose of methadone for same-day ambulatory surgery...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29794277/low-dose-ketamine-versus-morphine-for-acute-severe-vaso-occlusive-pain-in-children-a-randomized-controlled-trial
#11
Felix Anthony Lubega, Mithrika S DeSilva, Deogratias Munube, Rita Nkwine, Janat Tumukunde, Peter K Agaba, Mary T Nabukenya, Fred Bulamba, Tonny S Luggya
BACKGROUND AND AIMS: Acute pain episodes associated with sickle cell disease (SCD) are very difficult to manage effectively. Opioid tolerance and side effects have been major roadblocks in our ability to provide these patients with adequate pain relief. Ketamine is cheap, widely safe, readily available drug, with analgesic effects at sub-anesthetic doses and has been used in wide range of surgeries, pediatric burns dressing change and cancer related pain however, literature concerning its use in sickle cell crises is still limited in our setting...
January 26, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29777388/a-retrospective-study-of-opioid-prescribing-patterns-at-hospital-discharge-in-surgical-patients-with-obstructive-sleep-apnea
#12
Samir M Kendale, Jing Wang, Jeanna D Blitz, Steven Calvino, Germaine Cuff, Nicholas Barone, Andrew D Rosenberg, Lisa Doan
PURPOSE: Obstructive sleep apnea (OSA) is a risk factor for complications with postoperative opioid use, and in those patients with known or suspected OSA, minimization of postoperative opioids is recommended. We hypothesize that despite these recommendations, surgical patients with known or suspected OSA are prescribed postoperative opioids at hospital discharge at similar doses to those without OSA. METHODS: This was a retrospective analysis of the electronic health records of surgical patients from 1 November 2016 to 30 April 2017 at a single academic institution...
May 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29769132/toots-tastes-and-tester-shots-user-accounts-of-drug-sampling-methods-for-gauging-heroin-potency
#13
Sarah G Mars, Jeff Ondocsin, Daniel Ciccarone
BACKGROUND: Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. METHODS: Between 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption...
May 16, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#14
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
June 4, 2018: Pain
https://www.readbyqxmd.com/read/29759061/role-of-ultrasound-guided-transversus-abdominis-plane-block-as-a-component-of-multimodal-analgesic-regimen-for-lower-segment-caesarean-section-a-randomized-double-blind-clinical-study
#15
Ashok Jadon, Priyanka Jain, Swastika Chakraborty, Mayur Motaka, Sudhansu Sekhar Parida, Neelam Sinha, Amit Agrawal, Asit Kumar Pati
BACKGROUND: While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block has been postulated to provide effective analgesia for caesarean section. We evaluated the analgesic efficacy of this block for post caesarean analgesia in a randomised controlled trial. METHODS: One hundred thirty-nine mothers undergoing caesarean delivery were randomised to receive TAP block with either 20 ml 0...
May 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29756393/opioid-prescribing-practices-in-patients-undergoing-surgery-for-oral-cavity-cancer
#16
John Pang, Kathryn R Tringale, Viridiana J Tapia, Bharat A Panuganti, Jesse R Qualliotine, Aria Jafari, Sunny J Haft, Lawrence S Friedman, Timothy Furnish, Kevin T Brumund, Joseph A Califano, Charles S Coffey
OBJECTIVES: Opioids have been overprescribed after general and orthopedic surgeries, but prescribing patterns have not been reported for head and neck surgery. The objectives of this retrospective review are to describe postoperative opioid prescriptions after oral cancer surgery and determine which patients receive higher amounts. METHODS: A single institution retrospective review was performed for 81 adults with oral cavity tumors undergoing surgery. Opioid prescriptions upon discharge were reported in daily oral morphine equivalents (OME)...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29705547/nociceptin-orphanin-fq-receptors-modulate-the-discriminative-stimulus-effects-of-oxycodone-in-c57bl-6-mice
#17
D Matthew Walentiny, Jason M Wiebelhaus, Patrick M Beardsley
BACKGROUND: Nociceptin/orphanin FQ (NOP) receptor ligands have shown efficacy as putative analgesics and can modulate the abuse-related effects of opioids, suggesting therapeutic applications. The discriminative stimulus effects of a drug are related to their subjective effects, a predictor of abuse potential. To determine whether activation of NOP receptors could alter the subjective effects of an abused opioid analgesic, a novel oxycodone discrimination was established in mice, characterized with positive and negative controls, and its expression evaluated with a NOP receptor agonist...
June 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29701557/stereotactic-radiosurgery-for-trigeminal-pain-secondary-to-recurrent-malignant-skull-base-tumors
#18
Jack Phan, Courtney Pollard, Paul D Brown, Nandita Guha-Thakurta, Adam S Garden, David I Rosenthal, Clifton D Fuller, Steven J Frank, G Brandon Gunn, William H Morrison, Jennifer C Ho, Jing Li, Amol J Ghia, James N Yang, Dershan Luo, He C Wang, Shirley Y Su, Shaan M Raza, Paul W Gidley, Ehab Y Hanna, Franco DeMonte
OBJECTIVE The objective of this study was to assess outcomes after Gamma Knife radiosurgery (GKRS) re-irradiation for palliation of patients with trigeminal pain secondary to recurrent malignant skull base tumors. METHODS From 2009 to 2016, 26 patients who had previously undergone radiation treatment to the head and neck received GKRS for palliation of trigeminal neuropathic pain secondary to recurrence of malignant skull base tumors. Twenty-two patients received single-fraction GKRS to a median dose of 17 Gy (range 15-20 Gy) prescribed to the 50% isodose line (range 43%-55%)...
April 27, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29698106/effects-of-morphine-on-respiratory-load-detection-load-magnitude-perception-and-tactile-sensation-in-obstructive-sleep-apnea
#19
Rodrigo Tomazini Martins, Jayne C Carberry, Simon C Gandevia, Jane E Butler, Danny J Eckert
Pharyngeal and respiratory sensation is impaired in obstructive sleep apnea (OSA). Opioids may further diminish respiratory sensation. Thus, protective pharyngeal neuromuscular and arousal responses to airway occlusion that rely on respiratory sensation could be impaired with opioids to worsen OSA severity. However, little is known about the effects of opioids on upper airway and respiratory sensation in people with OSA. This study was designed to determine the effects of 40mg of MS-Contin on tactile sensation, respiratory load detection and respiratory magnitude perception in people with OSA during wakefulness...
April 26, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29661389/esketamine-counters-opioid-induced-respiratory-depression
#20
K Jonkman, E van Rijnsoever, E Olofsen, L Aarts, E Sarton, M van Velzen, M Niesters, A Dahan
BACKGROUND: Opioids can produce life-threatening respiratory depression. This study tested whether subanaesthetic doses of esketamine stimulate breathing in an established human model of opioid-induced respiratory depression. METHODS: In a study with a randomised, double blind, placebo controlled, crossover design, 12 healthy, young volunteers of either sex received a dose escalating infusion of esketamine (cumulative dose 40 mg infused in 1 h) on top of remifentanil-induced respiratory depression...
May 2018: British Journal of Anaesthesia
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