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https://www.readbyqxmd.com/read/28743151/-remifentanil-up2date-part-1
#1
Stefan Bushuven, Sascha Kreuer, Peter Kranke
Remifentanil is a short-acting opioid of high analgetic potency and superior controllability. It is widely used in day-case surgery, procedural sedation, for reduction of recovery-times and obstetrics and whenever excellent controllability of opioid effects is needed. Especially in combination with Propofol it is used for target-controlled infusion (TCI). The first part of the article provides readers with information about historical aspects, pharmacological characteristics, effects and side effects of remifentanil...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28740422/preoperative-intravenous-ibuprofen-does-not-influence-postoperative-narcotic-use-in-patients-undergoing-elective-hernia-repair-a-randomized-double-blind-placebo-controlled-prospective-trial
#2
Lauren S Sparber, Christine Sm Lau, Tanya S Vialet, Ronald S Chamberlain
INTRODUCTION: Inguinal and umbilical hernia repairs are among the most common surgical procedures performed in the US. Optimal perioperative pain control regimens remain challenging and opioid analgesics are commonly used. Preoperative nonsteroidal anti-inflammatory drug (NSAID) administration has been shown to reduce postoperative narcotic requirements. This study sought to evaluate the efficacy of perioperative intravenous (IV) ibuprofen on postoperative pain level and narcotic use in patients undergoing open or laparoscopic inguinal and/or umbilical hernia repair...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28739777/establishment-of-a-comprehensive-drug-overdose-fatality-surveillance-system-in-kentucky-to-inform-drug-overdose-prevention-policies-interventions-and-best-practices
#3
Sarah L Hargrove, Terry L Bunn, Svetla Slavova, Dana Quesinberry, Tracey Corey, William Ralston, Michael D Singleton, Van Ingram
BACKGROUND: According to the National Center for Health Statistics, Kentucky had the third highest drug overdose fatality rate in the nation in 2015 at 29.9 drug overdose fatalities per 100 000 population. OBJECTIVE: The elevated drug overdose fatality rate necessitated the development and implementation of a comprehensive multisource drug overdose fatality surveillance system (DOFSS). METHODS: DOFSS stakeholder work group members and data sources were identified, and memorandums of understanding were established...
July 24, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28736104/opioid-induced-constipation-relief-of-fixed-ratio-combination-prolonged-release-oxycodone-naloxone-compared-with-oxycodone-and-morphine-for-chronic-non-malignant-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
REVIEW
Lang Huang, Jian-Guo Zhou, Yu Zhang, Fei Wang, Yi Wang, Da-Hai Liu, Xin-Juan Li, Shui-Ping Lv, Su-Han Jin, Yu-Ju Bai, Hu Ma
BACKGROUND: Opioid-induced constipation (OIC) is one of the most frequent and severe adverse events (AEs) following treatment with opioids. Recent studies have indicated that fixed-ratio combination prolonged-release oxycodone/naloxone (OXN PR) could decrease OIC with similar pain relief compared with other opioids. OBJECTIVES: We systematically reviewed (PROSPERO registration numbers: CRD42016036244) the constipation relief of OXN PR compared with other opioids regardless of formulation, prolonged-release or extended-release used for the relief of chronic pain...
July 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28735775/heroin-uncertainties-exploring-users-perceptions-of-fentanyl-adulterated-and-substituted-heroin
#5
Daniel Ciccarone, Jeff Ondocsin, Sarah G Mars
BACKGROUND: The US is experiencing an unprecedented opioid overdose epidemic fostered in recent years by regional contamination of the heroin supply with the fentanyl family of synthetic opioids. Since 2011 opioid-related overdose deaths in the East Coast state of Massachusetts have more than tripled, with 75% of the 1374 deaths with an available toxicology positive for fentanyl. Fentanyl is 30-50X more potent than heroin and its presence makes heroin use more unpredictable. A rapid ethnographic assessment was undertaken to understand the perceptions and experiences of people who inject drugs sold as 'heroin' and to observe the drugs and their use...
July 11, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28735077/opioid-medication-misuse-among-unhealthy-drinkers
#6
Gerald Cochran, Rebecca McCarthy, Adam J Gordon, Ralph E Tarter
BACKGROUND: Combining opioid medications and alcohol has serious implications for patient health, including overdose. Information regarding those who use/misuse opioid medications and engage in unhealthy alcohol use is limited to pharmacological and epidemiological descriptions. This study presents opioid medication misuse and behavioral, mental, and physical health characteristics of persons filling opioid medications that are engaged in unhealthy alcohol use. METHODS: We conducted a cross-sectional survey at 5 community pharmacies in Southwestern, Pennsylvania among patients filling opioid medications...
July 14, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28734765/ampakines-and-morphine-provide-complementary-analgesia
#7
Yongjun Sun, Kevin Liu, Erik Martinez, Jahrane Dale, Dong Huang, Jing Wang
Glutamate signaling in the central nervous system is known to play a key role in pain regulation. AMPAkines can enhance glutamate signaling through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. previous studies have shown that AMPAkines are effective analgesic agents, and their site of action is likely in the brain. It is not known, however, if AMPAkines can provide complementary analgesia in combination with opioids, the most commonly used analgesics. Here, we show that the co-administration of an AMPAkine with morphine can provide additional analgesia, both in naïve rats and in rats that experience postoperative pain...
July 19, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28733920/complementary-and-alternative-medicine-among-persons-living-with-hiv-in-the-era-of-combined-antiretroviral-treatment
#8
Sean N Halpin, Edwin Clayton Carruth, Ramona P Rai, E Jennifer Edelman, David A Fiellin, Cynthia Gibert, Kirsha S Gordon, Wei Huang, Amy Justice, Vincent C Marconi, David Rimland, Molly M Perkins
Complementary and alternative medicine (CAM), often pursued independent of prescribing clinicians, may interact with traditional treatments, yet CAM use has not been well characterized among people living with HIV (PLWH) in the combined antiretroviral therapy (ART) era. We analyzed data from the Veterans Aging Cohort Study (October 2012-April 2015) to characterize CAM use in PLWH on ART. CAM users were more likely to have lived longer with HIV, report more bothersome symptoms, be prescribed more benzodiazepines and opioids, and consume less nicotine and alcohol...
July 21, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28732754/what-is-the-quality-of-online-resources-about-pain-control-after-total-knee-arthroplasty
#9
William W Schairer, Cynthia A Kahlenberg, Peter K Sculco, Benedict U Nwachukwu
BACKGROUND: With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). METHODS: We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject...
June 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#10
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28731876/neuraxial-drug-delivery-for-the-management-of-cancer-pain-cost-updates-and-society-guidelines
#11
Collin F M Clarke
PURPOSE OF REVIEW: The present study discusses the utilization of neuraxial drug delivery (NDD) for the management of cancer pain, based on recent trials, reviews, and guidelines with a focus on cost analysis. RECENT FINDINGS: Almost all recent publications suggest that more stringent research is needed to improve evidence on NDD, particularly as conflicting reports exist regarding cost effectiveness of drug delivery systems. The combination of local anesthetics and opioids, with or without clonidine, continues to be reported as beneficial with the utilization of patient controlled systems providing an advantage over continuous ones...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28729062/pharmacological-activation-of-ampk-inhibits-incision-evoked-mechanical-hypersensitivity-and-the-development-of-hyperalgesic-priming-in-mice
#12
Michael D Burton, Dipti V Tillu, Khadijah Mazhar, Galo L Mejia, Marina N Asiedu, Kufreobong Inyang, Travis Hughes, Bo Lian, Gregory Dussor, Theodore J Price
New therapeutics to manage post-surgical pain are needed to mitigate the liabilities of opioid and other analgesics. Our previous work shows that key modulators of excitability in peripheral nociceptors, such as extracellular signal-regulated kinases (ERK) are inhibited by activation of adenosine monophosphate activated protein kinase (AMPK). We hypothesized that AMPK activation would attenuate acute incision-evoked mechanical hypersensitivity and the development of hyperalgesic priming caused by surgery in mice...
July 17, 2017: Neuroscience
https://www.readbyqxmd.com/read/28727706/opioids-for-ocular-pain-a-narrative-review
#13
Vinicius Bp Pereira, Renato Garcia, Andre Am Torricelli, Samir J Bechara
BACKGROUND: Refractive surgery is a common procedure, but may be associated with severe post-operative pain. OBJECTIVES: To describe studies addressing the use of opioids for control of pain after ocular surgery, with an emphasis on refractive surgery. STUDY DESIGN: This is a narrative review of relevant articles on the physiology of corneal pain and the use of opioids for its treatment after surgery. SETTING: Single tertiary center...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727704/evaluating-the-adjuvant-effect-of-dexamethasone-to-ropivacaine-in-transversus-abdominis-plane-block-for-inguinal-hernia-repair-and-spermatocelectomy-a-randomized-controlled-trial
#14
Robert Wegner, Duane Akwar, Sarah Guzman-Reyes, Greesha Pednekar, Rabail Chaudhry, Navneet Grewal, Naveen Kukreja, Omar L Mancillas, George W Williams, Omonele Nwokolo
BACKGROUND: The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28723731/the-combined-effect-of-cyp2b6-genotype-and-other-candidate-genes-on-a-steady-state-serum-concentration-of-methadone-in-opioid-maintenance-treatment
#15
Marianne K Kringen, Fatemeh Chalabianloo, Jean-Paul Bernard, Jørgen G Bramness, Espen Molden, Gudrun Høiseth
BACKGROUND: A considerable inter-individual variability in methadone pharmacokinetics is seen in patients on methadone maintenance treatment. The aim of this study was to clarify the impact of the reduced function CYP2B6*6 variant allele together with variants in other candidate genes on a steady-state methadone concentration in a naturalistic setting. METHODS: Information of methadone serum concentration, dose, age, gender and CYP2C9, CYP2C19, and CYP2D6 genotypes were collected from a routine therapeutic drug monitoring (TDM) database while variant alleles in CYP2B6 and CYP3A5 were retrospectively genotyped...
July 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28721822/opioid-antagonists-for-pharmacological-treatment-of-gambling-disorder-are-they-relevant
#16
Caroline Victorri-Vigneau, Andrew Spiers, Pascal Caillet, Mélanie Bruneau, Gaëlle Challet-Bouju, Marie Grall-Bronnec
Background To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective This study aims to evaluate the relevance of opioid antagonists for treating GD. Method A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed...
July 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#17
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28721089/combination-treatment-of-neuropathic-pain-danish-expert-recommendations-based-on-a-delphi-process
#18
EDITORIAL
Jakob Vormstrup Holbech, Anne Jung, Torsten Jonsson, Mette Wanning, Claus Bredahl, Flemming W Bach
BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combination therapy had not been included in guidelines until recently. Based on clinical empiricism and scientific evidence, a Delphi consensus process provided a consolidated guidance on pharmacological combination treatment of NeP...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28719884/increases-from-2002-to-2015-in-prescription-opioid-overdose-deaths-in-combination-with-other-substances
#19
Denise B Kandel, Mei-Chen Hu, Pamela Griesler, Melanie Wall
BACKGROUND: Prescription opioid (PO) overdose deaths increased sharply over the last decade. Changes in PO deaths in combination with other psychoactive substances may provide a partial explanation. METHODS: PO deaths from the National Multiple-Cause-of-Death Files for 2002-03 (N=15,973) and 2014-15 (N=41,491) were analyzed. We calculated (1) changes in proportions of deaths in combination with benzodiazepines, antidepressants, heroin, alcohol, cocaine between the two periods, and (2) proportions of increase in deaths attributable to each substance among PO and synthetic opioids other than methadone (SO-M) deaths, by age, gender, race/ethnicity...
July 4, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28719060/drug-use-and-phylogenetic-clustering-of-hepatitis-c-virus-infection-among-people-who-use-drugs-in-vancouver-canada-a-latent-class-analysis-approach
#20
Brendan Jacka, Bethany Bray, Tanya L Applegate, Brandon Dl Marshall, Viviane Dias Lima, Kanna Hayashi, Kora DeBeck, Jayna Raghwani, P Richard Harrigan, Mel Krajden, Julio Montaner, Jason Grebely
BACKGROUND: This study estimated latent classes (i.e., unobserved subgroups in a population) of people who use drugs in Vancouver, Canada and examined how these classes relate to phylogenetic clustering of hepatitis C virus (HCV) infection. METHODS: HCV antibody positive people who use drugs from two cohorts in Vancouver, Canada (1996-2012) with a Core-E2 sequence were included. Time-stamped phylogenetic trees were inferred and phylogenetic clustering was determined by time to most common recent ancestor...
July 18, 2017: Journal of Viral Hepatitis
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