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https://www.readbyqxmd.com/read/29138592/dose-related-beneficial-and-harmful-effects-of-gabapentin-in-postoperative-pain-management-post-hoc-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#1
REVIEW
Maria Louise Fabritius, Jørn Wetterslev, Ole Mathiesen, Jørgen B Dahl
Background: During the last 15 years, gabapentin has become an established component of postoperative pain treatment. Gabapentin has been employed in a wide range of doses, but little is known about the optimal dose, providing the best balance between benefit and harm. This systematic review with meta-analyses aimed to explore the beneficial and harmful effects of various doses of gabapentin administered to surgical patients. Materials and methods: Data in this paper were derived from an original review, and the subgroup analyses were predefined in an International Prospective Register of Systematic Reviews published protocol: PROSPERO (ID: CRD42013006538)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29080097/hydromorphone-hydrochloride-use-during-various-interventional-radiology-procedures-pain-control-and-adverse-events-a-case-series-audit-analysis
#2
Thea Moran, Amit Prabhakar, James H Diaz, Alan David Kaye
INTRODUCTION: This project studied pain control and the development of adverse events before, during, and after the administration of hydromorphone hydrochloride for various interventional radiology (IR) procedures. METHODS: We performed a retrospective analysis of 100 patients (men = 58; women = 42) sedated with peri-procedural intravenous (IV) hydromorphone in association with various IR procedures. We stratified the procedures as follows: abscess drainages (M = 8; F = 8), arteriograms (M = 1; F = 0), biliary interventions (M = 3; F = 2), bone biopsies (M = 2; F = 2), non-bone biopsies (M = 26; F = 19), non-tunneled venous catheters (M = 1; F = 1), tunneled venous catheters (M = 7; F = 5), embolization (M = 4; F = 0), IVC filter placement (M = 1; F = 1), nephrostomy tube placement (M = 1; F = 4), and percutaneous nephrolithotomy tube placements (M = 4; F = 0)...
October 27, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29064627/interpreting-the-effectiveness-of-opioids-and-pregabalin-for-pain-severity-pain-interference-and-fatigue-in-fibromyalgia-patients
#3
Fred Davis, Mark Gostine, Bradley A Roberts, Rebecca Risko, Joseph C Cappelleri, Alesia Sadosky
OBJECTIVE: To evaluate the effectiveness of opioids and/or pregabalin on patient-reported outcomes among fibromyalgia (FM) patients based on levels of improvement. METHODS: A total of 1,421 FM patients were identified with 3,082 observational periods of opioids with or without pregabalin use between April 2008 and February 2015. Patients were categorized by opioids, and pregabalin with and without opioids; opioids were designated by morphine equivalent dose (MED) of ≤20 (low MED), >20 to <100 (moderate MED), ≥100 (high MED), and pregabalin dosages ≤150mg, 151- 300mg, and 301-450mg...
October 24, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29032350/identifying-characteristics-of-the-most-severely-impaired-chronic-pain-patients-treated-at-a-specialized-inpatient-pain-clinic
#4
Eva-Britt Hysing, Lena Smith, Mans Thulin, Rolf Karlsten, Stephen Butler, Torsten Gordh
BACKGROUND AND AIMS: Patients suffering from chronic nonmalignant pain constitute a heterogeneous population in terms of clinical presentation and treatment results. Few data are available about what distinguishes different groups in this huge population of patients with chronic persistent pain (CPP). A subgroup that is poorly studied, consists of the most severely impaired chronic pain patients. At the Uppsala University Hospital Pain Clinic, there is a specialized department accepting the most complex patients for rehabilitation...
October 12, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29021378/outcomes-of-a-specialized-interdisciplinary-approach-for-patients-with-cancer-with-aberrant-opioid-related-behavior
#5
Joseph Arthur, Tonya Edwards, Suresh Reddy, Kristy Nguyen, David Hui, Sriram Yennu, Minjeong Park, Diane Liu, Eduardo Bruera
BACKGROUND: Data on the development and outcomes of effective interventions to address aberrant opioid-related behavior (AB) in patients with cancer are lacking. Our outpatient supportive care clinic developed and implemented a specialized interdisciplinary team approach to manage patients with AB. The purpose of this study was to report clinical outcomes of this novel intervention. MATERIALS AND METHODS: The medical records of 30 consecutive patients with evidence of AB who received the intervention and a random control group of 70 patients without evidence of AB between January 1, 2015, and August 31, 2016, were reviewed...
October 11, 2017: Oncologist
https://www.readbyqxmd.com/read/28942715/pharmacokinetics-and-safety-of-fentanyl-sublingual-spray-and-fentanyl-citrate-intravenous-a-multiple-ascending-dose-study-in-opioid-na%C3%A3-ve-healthy-volunteers
#6
Richard L Rauck, D Alexander Oh, Neil Singla, Christian Koch, Neha Parikh, Srinivas Nalamachu, Daniel Wilson, Jin Yu, Santosh Vetticaden
OBJECTIVE: Fentanyl sublingual spray, with its rapid onset for pain relief, may be efficacious in the management of acute or post-operative pain. Because patients in these settings may be opioid-naïve, the study was conducted to determine the safety, tolerability, and pharmacokinetics of multiple dose administration of fentanyl sublingual spray in an opioid-naïve population. METHODS: Fentanyl sublingual spray (100 mcg, 200 mcg, and 400 mcg) and fentanyl citrate intravenous (IV; 50 mcg) were administered every 0...
November 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28928552/comparative-efficacy-of-minimal-concentration-of-racemic-bupivacaine-0-0625-with-fentanyl-and-ropivacaine-0-1-with-fentanyl-for-epidural-labor-analgesia
#7
T N Chethanananda, M R Shashank, N Madhu, J Achyutha, Karna Venkata Siva Kumar
BACKGROUND AND AIMS: This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia. SETTINGS AND DESIGN: The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28888771/c-terminal-hydrazide-modification-changes-the-spinal-antinociceptive-profiles-of-endomorphins-in-mice
#8
Chang-Lin Wang, Dai-Jun Yang, Bi-Yu Yuan, Yu Wang
Previously, we have demonstrated that endomorphins (EMs) analogs with C-terminal hydrazide modification retained the μ-opioid receptor affinity and selectivity, and exhibited potent antinociception after intracerebroventricular (i.c.v.) administration. In the present study, we extended our studies to evaluate the antinociceptive profiles of EMs and their analogs EM-1-NHNH2, EM-2-NHNH2 given spinally in the radiant heat paw withdrawal test. Following intrathecal (i.t.) administration, EM-1, EM-2, EM-1-NHNH2 and EM-2-NHNH2 dose-dependently increased the latency for paw withdrawal response...
September 6, 2017: Peptides
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#9
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28769587/health-care-resource-use-and-cost-differences-by-opioid-therapy-type-among-chronic-noncancer-pain-patients
#10
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna O D'Souza, Sham L Chaudhari, Paul P Yeung, Richard White
The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), mono-therapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan(®) claims databases (2006-2012), we identified CNCP patients with ≥90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28742772/medication-errors-in-pediatric-anesthesia-a-report-from-the-wake-up-safe-quality-improvement-initiative
#11
Lauren M Y Lobaugh, Lizabeth D Martin, Laura E Schleelein, Donald C Tyler, Ronald S Litman
BACKGROUND: Wake Up Safe is a quality improvement initiative of the Society for Pediatric Anesthesia that contains a deidentified registry of serious adverse events occurring in pediatric anesthesia. The aim of this study was to describe and characterize reported medication errors to find common patterns amenable to preventative strategies. METHODS: In September 2016, we analyzed approximately 6 years' worth of medication error events reported to Wake Up Safe. Medication errors were classified by: (1) medication category; (2) error type by phase of administration: prescribing, preparation, or administration; (3) bolus or infusion error; (4) provider type and level of training; (5) harm as defined by the National Coordinating Council for Medication Error Reporting and Prevention; and (6) perceived preventability...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28740797/pain-management-in-abdominal-wall-reconstruction
#12
Ibrahim Khansa, Andrew Koogler, Jesse Richards, Richard Bryant, Jeffrey E Janis
BACKGROUND: In abdominal wall reconstruction, adequate pain control and minimization of narcotic consumption are essential to improving patient outcomes and satisfaction. Previous studies have examined the role of individual strategies, such as neuraxial analgesia and multimodal analgesia. However, there has not been a study that examined all potential determinants of postoperative narcotic requirements, including intraoperative strategies. METHODS: Consecutive patients who underwent abdominal wall reconstruction were reviewed...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28711636/factors-influencing-long-term-opioid-use-among-opioid-naive-patients-an-examination-of-initial-prescription-characteristics-and-pain-etiologies
#13
Anuj Shah, Corey J Hayes, Bradley C Martin
The relationships between the initial opioid prescription characteristics and pain etiology with the probability of opioid discontinuation were explored in this retrospective cohort study using health insurance claims data from a nationally representative database of commercially insured patients in the United States. We identified 1,353,902 persons aged 14 years and older with no history of cancer or substance abuse, with new opioid use episodes and categorized them into 11 mutually exclusive pain etiologies...
November 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28658164/the-analgesic-efficacy-of-oxycodone-hydrochloride-versus-fentanyl-during-outpatient-artificial-abortion-operation-a-randomized-trial
#14
RANDOMIZED CONTROLLED TRIAL
Kangjie Xie, Wen Zhang, Wumei Fang, Yanhong Lian, Sufeng Lin, Jun Fang
BACKGROUND: Problems like body movement, respiratory depression, and complained of pain are still common phenomenon in outpatient artificial abortion general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid and has a good therapeutic effect on visceral pain. We hypothesize that oxycodone hydrochloride would be superior to fentanyl in outpatient artificial abortion surgery. METHODS: In this clinical trial 149 American Society of Anesthesiologists (ASA) I or II female outpatients scheduled for elective artificial abortion surgeries under general anesthesia were randomly divided into 3 groups: oxycodone hydrochloride 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28595427/challenging-equipotency-calculation-for-hydromorphone-after-long-term-intravenous-application
#15
Benjamin Luchting, Banafscheh Rachinger-Adam, Nikolai Hulde, Jens Heyn, Shahnaz Christina Azad
In advanced stages, most cancer patients suffer from pain which can usually be well controlled following the World Health Organization (WHO) level scheme. While the majority of patients report adequate pain relief by strong opioids (WHO III), some require an opioid rotation. Despite the existence of conversion tables, these rotations mea lead to inadequate pain control or life threatening events. Here, we report about a patient with urothelial cell carcinoma presenting in our Department of Pain Medicine with massive pain aggravation up to NRS values of 10/10 despite administration of the highest dose of intravenously applied hydromorphone...
March 16, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28550642/post-heroin-dose-tissue-distribution-of-6-monoacetylmorphine-6-mam-with-maldi-imaging
#16
Belin G Teklezgi, Annapurna Pamreddy, Sooraj Baijnath, Nirmala D Gopal, Tricia Naicker, Hendrik G Kruger, Thavendran Govender
Heroin is an illicit opioid drug which is commonly abused and leads to dependence and addiction. Heroin is considered a pro-drug and is rapidly converted to its major active metabolite 6-monoacetylmorphine (6-MAM) which mediates euphoria and reward through the stimulation of opioid receptors in the brain. The aim of this study was to investigate the distribution and localization of 6-MAM in the healthy Sprague Dawley rat brain following intraperitoneal (i.p) administration of heroin (10 mg/kg), using matrix-assisted laser desorption/ionization mass spectrometric imaging (MALDI-MSI), in combination with quantification via liquid chromatography mass spectrometry (LC-MS/MS)...
August 2017: Journal of Molecular Histology
https://www.readbyqxmd.com/read/28523735/variability-in-prescription-opioid-intake-and-reinforcement-amongst-129-substrains
#17
S M Jimenez, A F Healy, M A Coelho, C N Brown, T E Kippin, K K Szumlinski
Opioid abuse in the United States has reached epidemic proportions, with treatment admissions and deaths associated with prescription opioid abuse quadrupling over the past 10 years. Although genetics are theorized to contribute substantially to inter-individual variability in the development, severity and treatment outcomes of opioid abuse/addiction, little direct preclinical study has focused on the behavioral genetics of prescription opioid reinforcement and drug-taking. Herein, we employed different 129 substrains of mice currently available from The Jackson Laboratory (129S1/SvlmJ, 129X1/SvJ, 129S4/SvJaeJ and 129P3/J) as a model system of genetic variation and assayed mice for oral opioid intake and reinforcement, as well as behavioral and somatic signs of dependence...
May 19, 2017: Genes, Brain, and Behavior
https://www.readbyqxmd.com/read/28476033/dexmedetomidine-plus-sufentanil-for-pediatric-flexible-bronchoscopy-a-retrospective-clinical-trial
#18
Xiujing Dang, Weidong Hu, Zhendong Yang, Shiyu Su
Several studies have reported the use of dexmedetomidine (DEX) plus opioids for flexible bronchoscopy in both adults and children. To determine whether DEX plus sufentanil (SF) is safe for children, 142 children undergoing flexible bronchoscopy were assigned to one of three groups, each of which received the same SF loading dose and similar DEX and SF maintenance doses, but different loading doses of DEX: DS1 (DEX 0.5 μg·kg-1), DS2 (DEX 1.0 μg·kg-1), and DS3 (DEX 1.5 μg·kg-1). The Ramsay sedation scale was maintained at 3 in all groups...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414496/impaired-psychomotor-function-and-plasma-methadone-and-levo-alpha-acetylmethadol-laam-concentrations-in-opioid-substitution-patients
#19
RANDOMIZED CONTROLLED TRIAL
David A L Newcombe, Andrew A Somogyi, Felix Bochner, Jason M White
Tolerance to the psychomotor impairing effects of opioid drugs is expected to develop with repeated dosing, but may be incomplete. The relationship between plasma opioid concentration and psychomotor function in opioid-dependent patients was examined to determine whether impairment was more likely at the time of highest plasma drug concentration. Sixteen patients participating in a cross-over trial comparing methadone and LAAM completed a tracking task (OSPAT) 11 times over the dosing-interval for methadone (24-hrs) and LAAM (48-hrs)...
June 2017: Experimental and Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28376280/independent-and-interactive-effects-of-oprm1-and-dat1-polymorphisms-on-alcohol-consumption-and-subjective-responses-in-social-drinkers
#20
Elise M Weerts, Gary S Wand, Brion Maher, Xiaoqiang Xu, Mary Ann Stephens, Xiaoju Yang, Mary E McCaul
BACKGROUND: The current study examined independent and interactive effects of polymorphisms of the mu opioid receptor gene (OPRM1, A118G) and variable number tandem repeats of the dopamine transporter gene (DAT1, SLC6A3) on alcohol consumption and subjective responses to alcohol in 127 young, healthy, social drinkers. METHODS: Participants completed an in-person assessment, which included self-reported alcohol drinking patterns and blood sampling for DNA, and in a second visit, a cumulative alcohol dosing procedure with subjective ratings across multiple time points and breath alcohol contents (0...
June 2017: Alcoholism, Clinical and Experimental Research
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