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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
July 13, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28292508/pharmacy-based-statewide-naloxone-distribution-a-novel-top-down-bottom-up-approach
#15
Kate J Morton, Brianna Harrand, Carly Cloud Floyd, Craig Schaefer, Julie Acosta, Bridget Claire Logan, Karen Clark
OBJECTIVE: To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. SETTING: New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28263128/predictors-of-narcotic-use-after-percutaneous-nephrolithotomy
#16
Nazih Khater, Mohamed Keheila, Michelle Lightfoot, Jim Shen, Samuel Abourbih, Muhannad Alsyouf, Roger Li, D Duane Baldwin
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is associated with significant variability in postoperative pain and subsequent narcotic use. The purpose of this study was to determine the factors associated with high narcotic use following PCNL. MATERIALS AND METHODS: A single-center retrospective review of patients undergoing initial PCNL between 2004 and 2014 was performed. Preoperative, intraoperative and postoperative factors associated with postoperative narcotic usage were analyzed...
February 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28252574/abcb1-polymorphisms-and-cold-pressor-pain-responses-opioid-dependent-patients-on-methadone-maintenance-therapy
#17
Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
BACKGROUND: Methadone is a substrate of the P-glycoprotein efflux transporter, which is encoded by ABCB1 (MDR1), and thus, ABCB1 polymorphisms may influence the transport of methadone at the blood-brain barrier, affecting its adverse effects. OBJECTIVES: This study investigated the association between ABCB1 polymorphisms and cold pressor pain responses among opioid-dependent patients on methadone maintenance therapy (MMT). METHODS: Malay male opioid-dependent patients receiving MMT (n = 148) were recruited...
March 2017: Nursing Research
https://www.readbyqxmd.com/read/28241764/changes-over-time-in-prescription-practices-of-pain-medications-in-switzerland-between-2006-and-2013-an-analysis-of-insurance-claims
#18
Maria M Wertli, Oliver Reich, Andri Signorell, Jakob M Burgstaller, Johann Steurer, Ulrike Held
BACKGROUND: In Europe, scant information is available about prescription practices for pain medications. The aim of this research was to assess changes in prescription rates of non-opioid, weak opioid, and strong opioid medications between 2006 and 2013 in the Swiss population. METHODS: Using insurance claims data covering one-sixth of the Swiss population, we analyzed the numbers of reimbursed pain medications, the number of reimbursements per persons, and the cumulative dose in milligrams...
February 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152878/time-trends-in-opioid-use-in-cancer-and-noncancer-patients-observations-from-administrative-data
#19
Carlo DeAngelis, Craig Earle, Clare Atzema, Deborah Jane Dudgeon, Tara Gomes, Doris Howell, Amna Husain, Mary Ann O'Brien, Hsien Seow, Jonathan Sussman, Rinku Sutradhar, Anna Chu, Ying Liu
298 Background: Opioid prescribing has been increasingly scrutinized in the non-cancer patient population due to concerns with morbidity, mortality and diversion. Resulting regulatory changes have decreased prescribing. As an unintended consequence, we hypothesized that cancer patients might be similarly impacted. METHODS: All Ontario residents ≥ 65 years are eligible for government paid pharmacare. For each year from 2004 to 2013, Ontarians ≥ 65 years were stratified into 3 groups: no cancer history, cancer diagnosis > 5 years ago and cancer diagnosis ≤ 5 years ago...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28089852/dopamine-d1-receptor-agonist-treatment-attenuates-extinction-of-morphine-conditioned-place-preference-while-increasing-dendritic-complexity-in-the-nucleus-accumbens-core
#20
Kendra L Kobrin, Danielle T Arena, Stephen C Heinrichs, Olivia H Nguyen, Gary B Kaplan
The dopamine D1 receptor (D1R) has a role in opioid reward and conditioned place preference (CPP), but its role in CPP extinction is undetermined. We examined the effect of D1R agonist SKF81297 on the extinction of opioid CPP and associated dendritic morphology in the nucleus accumbens (NAc), a region involved with reward integration and its extinction. During the acquisition of morphine CPP, mice received morphine and saline on alternate days; injections were given immediately before each of eight daily conditioning sessions...
March 30, 2017: Behavioural Brain Research
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