keyword
https://read.qxmd.com/read/38426254/opioid-free-anaesthesia-should-we-all-adopt-it-an-overview-of-current-evidence-a-reply
#21
JOURNAL ARTICLE
Helene Beloeil, Girish P Joshi
No abstract text is available yet for this article.
April 1, 2024: European Journal of Anaesthesiology
https://read.qxmd.com/read/38420357/efficacy-of-erector-spine-plane-block-in-two-different-approaches-to-lumbar-spinal-fusion-surgery-a-retrospective-pilot-study
#22
JOURNAL ARTICLE
Jānis Verners Birnbaums, Agnese Ozoliņa, Leonids Solovjovs, Zane Glāzniece-Kagane, Jānis Nemme, Ināra Logina
BACKGROUND: Erector spine plane block (ESPB) has been widely used in spinal surgery, although there are variable data about its efficacy. OBJECTIVES: This study aimed to evaluate the efficacy of ESPB in elective lumbar spinal fusion surgery patients with two different surgical approaches. MATERIALS AND METHODS: Retrospectively, 45 elective lumbar transpedicular fusion (TPF) surgery patients undergoing open surgery with different approaches [posterior transforaminal fusion approach (TLIF) or combined posterior and anterior approach (TLIF+ALIF)] were divided into 2 groups: general anesthesia (GA, n  = 24) and general anesthesia combined with ESPB (GA + ESPB, n  = 21)...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38414500/systematic-review-on-intentional-non-medical-fentanyl-use-among-people-who-use-drugs
#23
Vivian W L Tsang, James S H Wong, Jean N Westenberg, Noor H Ramadhan, Hasti Fadakar, Mohammadali Nikoo, Victor W Li, Nick Mathew, Pouya Azar, Kerry L Jang, Reinhard M Krausz
OBJECTIVES: Fentanyl is a highly potent opioid and has, until recently, been considered an unwanted contaminant in the street drug supply among people who use drugs (PWUD). However, it has become a drug of choice for an increasing number of individuals. This systematic review evaluated intentional non-medical fentanyl use among PWUD, specifically by summarizing demographic variance, reasons for use, and resulting patterns of use. METHODS: The search strategy was developed with a combination of free text keywords and MeSH and non-MeSH keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO...
2024: Frontiers in Psychiatry
https://read.qxmd.com/read/38413029/thermoresponsive-polymeric-hydromorphone-prodrug-provides-sustained-local-analgesia-without-apparent-adverse-effects
#24
JOURNAL ARTICLE
Zhenshan Jia, Xin Wei, Ningrong Chen, Xiaoke Xu, Gang Zhao, Xin Fu, Hanjun Wang, Mary B Goldring, Steven R Goldring, Dong Wang
The extensive use of opioids for chronic pain management has contributed significantly to the current opioid epidemic. While many alternative nonopioid analgesics are available, opioids remain the most potent analgesics for moderate to severe pain management. In addition to the implementation of multimodal analgesia, there is a pressing need for the development of more effective and safer opioids. In this study, we developed a thermoresponsive N -(2-hydroxypropyl) methacrylamide (HPMA) copolymer-based hydromorphone (HMP) prodrug (ProGel-HMP, HMP content = 16...
February 27, 2024: Molecular Pharmaceutics
https://read.qxmd.com/read/38411964/effect-of-a-co-located-bridging-recovery-initiative-on-hospital-length-of-stay-among-patients-with-opioid-use-disorder-the-bridge-randomized-clinical-trial
#25
RANDOMIZED CONTROLLED TRIAL
David Marcovitz, Mary Lynn Dear, Rebecca Donald, David A Edwards, Kristopher A Kast, Thao D V Le, Mauli V Shah, Jason Ferrell, Cheryl Gatto, Cassandra Hennessy, Reagan Buie, Todd W Rice, William Sullivan, Katie D White, Grace Van Winkle, Rachel Wolf, Christopher J Lindsell
IMPORTANCE: Co-located bridge clinics aim to facilitate a timely transition to outpatient care for inpatients with opioid use disorder (OUD); however, their effect on hospital length of stay (LOS) and postdischarge outcomes remains unclear. OBJECTIVE: To evaluate the effect of a co-located bridge clinic on hospital LOS among inpatients with OUD. DESIGN, SETTING, AND PARTICIPANTS: This parallel-group randomized clinical trial recruited 335 adult inpatients with OUD seen by an addiction consultation service and without an existing outpatient clinician to provide medication for OUD (MOUD) between November 25, 2019, and September 28, 2021, at a tertiary care hospital affiliated with a large academic medical center and its bridge clinic...
February 5, 2024: JAMA Network Open
https://read.qxmd.com/read/38410320/perioperative-management-conundrum-for-a-case-with-multiple-commonly-used-drug-hypersensitivity
#26
Vikash Bansal, Habib Md R Karim, Abhishek K Rai, Dipak Bhuyan, Sanjay Kumar
Perioperative hypersensitivity reactions vary from mild to potentially fatal anaphylaxis, resulting in significant morbidity and mortality. Most of the perioperative hypersensitivity and allergic reactions are attributed to antibiotics, antiseptic solutions, latex, and opioids. In the current thrust for opioid-free anesthesia, owing to its multiple advantages, paracetamol and nonsteroidal antiinflammatory agents play a significant role in multi-modal pain and inflammatory response management. Nearly nine out of ten individuals experience postoperative pain, one-third experience postoperative nausea and vomiting, and one-fourth experience fever, irrespective of surgery and type of anesthesia, often as an inflammatory response...
January 2024: Curēus
https://read.qxmd.com/read/38409359/opioid-free-anesthesia-with-ultrasound-guided-quadratus-lumborum-block-in-the-supine-position-for-lower-abdominal-or-pelvic-surgery-a-randomized-controlled-trial
#27
JOURNAL ARTICLE
Jingwei Dai, Shanliang Li, Qijun Weng, Jinxiong Long, Duozhi Wu
In the past, quadratus lumborum block (QLB) was mostly used for postoperative analgesia in patients, and few anesthesiologists applied it during surgery with opioid-free anesthesia (OFA). Consequently, it is still unclear whether QLB in the supine position can provide perfect analgesia and inhibit anesthetic stress during surgery under the OFA strategy. To observe the clinical efficacy of ultrasound-guided quadratus lumborum block (US-QLB) in the supine position with OFA for lower abdominal and pelvic surgery...
February 26, 2024: Scientific Reports
https://read.qxmd.com/read/38371483/tedofa-trial-study-protocol-a-prospective-double-blind-randomized-controlled-clinical-trial-comparing-opioid-free-versus-opioid-anesthesia-on-the-quality-of-postoperative-recovery-and-chronic-pain-in-patients-receiving-thoracoscopic-surgery
#28
JOURNAL ARTICLE
Bijia Song, Xiuliang Li, Jiguang Yang, Wenjing Li, Lei Wan
INTRODUCTION: Seeking effective multimodal analgesia and anesthetic regimen is the basis for the success of ERAS. Opioid-free anesthesia (OFA) is a multimodal anesthesia associating hypnotics, N-methyl-D-aspartate (NMDA) antagonists, local anesthetics, anti-inflammatory drugs and α-2 agonists. Although previous studies have confirmed that OFA is safe and feasible for VATS surgery, there is great heterogeneity in how to select and combine anti-harm drugs to replace opioids. We hypothesized that the reduced opioid use during and after surgery allowed by OFA compared with standard of care will be associated with a reduction of postoperative opioid-related adverse events and an improvement in the quality of rehabilitation of patients after partial VATS lung resection...
2024: Journal of Pain Research
https://read.qxmd.com/read/38360686/opioid-reduction-and-enhanced-recovery-in-orthopaedic-surgery-oreos-a-protocol-for-a-feasibility-randomised-controlled-trial-in-patients-undergoing-total-knee-arthroplasty
#29
JOURNAL ARTICLE
Kim Madden, Sushmitha Pallapothu, Darren Young Shing, Anthony Adili, Mohit Bhandari, Lisa Carlesso, Moin Khan, Ydo V Kleinlugtenbelt, Adrijana Krsmanovic, Matilda Nowakowski, Tara Packham, Eric Romeril, Jean-Eric Tarride, Lehana Thabane, Daniel M Tushinski, Christine Wallace, Mitchell Winemaker, Harsha Shanthanna
BACKGROUND: Knee arthritis is a leading cause of limited function and long-term disability in older adults. Despite a technically successful total knee arthroplasty (TKA), around 20% of patients continue to have persisting pain with reduced function, and low quality of life. Many of them continue using opioids for pain control, which puts them at risk for potential long-term adverse effects such as dependence, overdose and risk of falls. Although persisting pain and opioid use after TKA have been recognised to be important issues, individual strategies to decrease their burden have limitations and multi-component interventions, despite their potential, have not been well studied...
February 15, 2024: Pilot and Feasibility Studies
https://read.qxmd.com/read/38360661/analgesic-efficacy-of-an-opioid-free-postoperative-pain-management-strategy-versus-a-conventional-opioid-based-strategy-following-laparoscopic-radical-gastrectomy-an-open-label-randomized-controlled-non-inferiority-trial
#30
RANDOMIZED CONTROLLED TRIAL
Zhimin Lin, Zhongbiao Chen, Yongliang Li
OBJECTIVE: In patients undergoing laparoscopic radical gastrectomy, the use of subcostal transversus abdominis plane block (STAPB) for completely opioid-free postoperative pain management lacks convincing clinical evidence. METHODS: This study included 112 patients who underwent laparoscopic radical gastrectomy at the 900TH Hospital of the Joint Logistics Support Force from October 2020 to March 2022. Patients were randomly divided into (1:1) continuous opioid-free STAPB (C-STAPB) group and conventional group...
February 15, 2024: World Journal of Surgical Oncology
https://read.qxmd.com/read/38348364/regenerative-peripheral-nerve-interface-rpni-surgery-for-mitigation-of-neuroma-and-postamputation-pain
#31
JOURNAL ARTICLE
Christine Sw Best, Paul S Cederna, Theodore A Kung
BACKGROUND: A neuroma occurs when a regenerating transected peripheral nerve has no distal target to reinnervate. Symptomatic neuromas are a common cause of postamputation pain that can lead to substantial disability1-3 . Regenerative peripheral nerve interface (RPNI) surgery may benefit patients through the use of free nonvascularized muscle grafts as physiologic targets for peripheral nerve reinnervation for mitigation of neuroma and postamputation pain. DESCRIPTION: An RPNI is constructed by implanting the distal end of a transected peripheral nerve into a free nonvascularized skeletal muscle graft...
2024: JBJS Essential Surgical Techniques
https://read.qxmd.com/read/38340677/a-phase-3-active-controlled-trial-of-liposomal-bupivacaine-via-sciatic-nerve-block-in-the-popliteal-fossa-after-bunionectomy
#32
JOURNAL ARTICLE
Gary Schwartz, Jeffrey C Gadsden, Jeffrey Gonzales, Jacob Hutchins, Jia Song, O'Dane Brady, Mary DiGiorgi, Roy Winston
STUDY OBJECTIVE: To investigate the efficacy, safety, pharmacodynamics, and pharmacokinetics of liposomal bupivacaine (LB) administered via ultrasound-guided sciatic nerve block in the popliteal fossa in participants undergoing bunionectomy. DESIGN: Two-part, randomized, double-blind, active-controlled trial (NCT05157841). SETTING: Operating room, postanesthesia care unit, and health care facility (6 sites). PATIENTS: Adults with American Society of Anesthesiologists physical status classification ≤3 and body mass index ≥18 to <40 kg/m2 undergoing elective distal metaphyseal osteotomy...
February 9, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38337394/a-randomized-comparison-of-multimodal-analgesia-and-fentanyl-based-patient-controlled-analgesia-in-women-undergoing-robot-assisted-bilateral-axillary-breast-approach-thyroidectomy
#33
JOURNAL ARTICLE
Na-Young Tae, Jin Wook Yi, Jong-Kwon Jung, Junhyung Lee, Sooman Jo, Hyunzu Kim
Opioid-free multimodal analgesia (MMA) emerges as a preferable approach for postoperative pain management compared to opioid-based patient-controlled analgesia (PCA) in robot-assisted bilateral axillary breast approach thyroidectomy, a procedure commonly undergone by young female patients. We compared the analgesic efficacy and other recovery profiles between MMA and PCA. In total, 88 female patients were administered fentanyl-based PCA or the combination of lidocaine continuous infusion and nefopam injection before recovery from general anesthesia...
January 25, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38336669/safety-and-effectiveness-of-opioid-free-anaesthesia-in-thoracoscopic-surgery-a-preliminary-retrospective-cohort-study
#34
JOURNAL ARTICLE
Shanshan Zhang, Jianmin Zhang, Ran Zhang
BACKGROUND: This study aimed to observe the effect of opioid-free anaesthesia (OFA) on intraoperative haemodynamic,postoperative analgesia and postoperative nausea and vomiting (PONV) in thoracoscopic surgery in order to provide more evidence for evaluating the safety and effectiveness of OFA technology. METHODS: This was a single-centre retrospective observational study.Adult patients who underwent thoracoscopic surgery with the preoperative thoracic paravertebral block between January 2017 and June 2020 were included...
February 9, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38335639/is-pain-empathy-associated-with-pain-indices-and-trauma-history-a-comparison-between-patients-receiving-methadone-maintenance-treatment-and-healthy-controls
#35
JOURNAL ARTICLE
Shlomit Zorani, Einat Peles
BACKGROUND: To study whether pain empathy and theory of mind (ToM) are related to pain indices and trauma experience, we studied opioid users receiving methadone maintenance treatment (MMT), a population with a history of traumas and a high prevalence of chronic pain. METHODS: MMT patients (n = 53), substance abuse-free, with no impaired cognition (Montreal Cognitive Assessment (MoCA) ≥24), were compared to healthy controls (HC) matched by age and gender (n = 66)...
February 2, 2024: Journal of Psychiatric Research
https://read.qxmd.com/read/38332965/the-bioavailability-of-chf6563-an-ethanol-free-sublingual-neonatal-buprenorphine-formulation-a-bridging-study-conducted-in-adults
#36
JOURNAL ARTICLE
Walter K Kraft, Irene Barneschi, Maria Bocchi, Debora Santoro, Massimo Cella
OBJECTIVE: Sublingual buprenorphine has demonstrated efficacy for treatment of the neonatal opioid withdrawal syndrome (NOWS), but the current formulation used in clinical practice contains 30% ethanol. Ethanol as a pharmacologically active excipient ideally should be removed from neonatal formulations. The objective of this study was to determine the relative bioavailability of a novel ethanol-free -formulation (CHF6563) compared with the commonly used ethanolic solution in a phase I, open-label, 2-period, -single-dose, crossover study in healthy adults...
2024: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://read.qxmd.com/read/38332901/differences-in-heroin-overdose-deaths-in-australia-by-age-2020-2022-disease-and-estimated-survival-times
#37
JOURNAL ARTICLE
Shane Darke, Johan Duflou, Amy Peacock, Michael Farrell, Julia Lappin
BACKGROUND: The age of people who use illicit opioids has increased, with a clinical picture of accelerated ageing. The study aimed to determine, stratified by age: 1. The circumstances and characteristics of heroin-related toxicity deaths in Australia, 2020-2022; 2. The toxicological profile and autopsy findings; 3. The proportion of cases in which blood 6-acetyl morphine (6AM) was detected, as a measure of survival time. METHODS: Retrospective study of 610 cases of fatal heroin-related drug toxicity in Australia, 2020-2022...
March 2024: Drug Alcohol Depend Rep
https://read.qxmd.com/read/38329115/prescription-opioids-induced-microbial-dysbiosis-worsens-severity-of-chronic-pancreatitis-and-drives-pain-hypersensitivity
#38
JOURNAL ARTICLE
Kousik Kesh, Junyi Tao, Nillu Ghosh, Richa Jalodia, Salma Singh, Rajinder Dawra, Sabita Roy
Opioids, such as morphine and oxycodone, are widely used for pain management associated with chronic pancreatitis (CP); however, their impact on the progression and pain sensitivity of CP has never been evaluated. This report investigates the impact of opioid use on the severity of CP, pain sensitivity, and the gut microbiome. C57BL/6 mice were divided into control, CP, CP with morphine/oxycodone, and either morphine or oxycodone alone groups. CP was induced by administration of caerulein (50ug/kg/h, i.p. hourly x7, twice a week for 10 weeks)...
2024: Gut Microbes
https://read.qxmd.com/read/38325047/a-novel-investigation-into-the-negative-impact-of-opioid-use-on-the-efficacy-of-immune-checkpoint-inhibitors-in-advanced-non-small-cell-lung-cancer-patients
#39
REVIEW
Huaijuan Guo, Yin Li, Jie Lin, Donglin Li, Jingjing Yang, Jiaxin Wang, Jingxian Mao, Ying Wang, Xuebing Yan
OBJECTIVE: Immune checkpoint inhibitors (ICIs) have effectively improved the clinical outcome of advanced non-small cell lung cancer (NSCLC). Opioids are commonly used for pain relief in cancer patients. This study aims to clarify the prognostic impact of opioid use in advanced NSCLC patients receiving ICI therapy. METHODS: A systematic literature review was carried out using online databases before July 2023. The meta-analysis was used to clarify the correlation of opioid use with the overall survival (OS) or progression-free survival (PFS) of ICI-treated NSCLC patients, both of which were determined using hazard ratios (HRs) coupled with 95 % confidence intervals (CIs)...
March 10, 2024: International Immunopharmacology
https://read.qxmd.com/read/38324355/inside-operation-change-agent-mallinckrodt-s-plan-for-capturing-the-opioid-market
#40
JOURNAL ARTICLE
Daniel Eisenkraft Klein, Ross Mackenzie, Ben Hawkins, Adam Koon
CONTEXT: The United States is deeply entangled in an opioid crisis that began with the overuse of prescription painkillers. At the height of the prescription opioid crisis (2006-2012), Mallinckrodt Pharmaceuticals was the largest opioid manufacturer. This study explores Mallinckrodt strategies to expand its market share by promoting a new opioid. METHODS: Using the Opioids Industry Document Archive, we analyzed the incentive structures, sales contests, and rhetorical strategy behind Mallinckrodt's "Operation Change Agent," a campaign to switch patients from OxyContin to Mallinckrodt-branded painkillers...
February 7, 2024: Journal of Health Politics, Policy and Law
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