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heroin addict and anesthesia

Nalini Vadivelu, Sukanya Mitra, Alan David Kaye, Richard D Urman
The epidemic use of illicit drugs has led to an increasing number of patients with drug addiction and dependence presenting for perioperative care. There are a wide variety of drugs commonly abused including opioids, such as heroin and prescription drugs; stimulants, such as amphetamine and cocaine; depressant drugs, such as alprazolam and diazepam; and hallucinogens, such as lysergic acid diethylamide, phencyclidine, and marijuana. Treatment of opioid dependence by office-based buprenorphine and methadone maintenance programs has expanded opportunities for therapy...
March 2014: Best Practice & Research. Clinical Anaesthesiology
Sheng Liu, Longhui Li, Wenwen Shen, Xueyong Shen, Guodong Yang, Wenhua Zhou
BACKGROUND: Easing psychological symptoms associated with heroin use and heroin relapse are important goals in the treatment of heroin dependence. However, most detoxification methods are designed to decrease withdrawal-related discomfort and complications, but not to reduce the psychological effects of heroin addiction. OBJECTIVE: The objective of this study was to evaluate the efficacy of scopolamine detoxification technique (SDT) relative to standard methadone detoxification (MD) to treat heroin withdrawal and psychological symptoms associated with heroin use and relapse...
December 2013: CNS Drugs
G Lerchl-Wanie, R Angster
In this review article the special anesthesiological problems of opioid tolerance and surgical interventions will be presented. These affect patients with a long-term opioid therapy of chronic pain, addicts with long-term substitution therapy and addicts with current or previous heroin addiction ("clean"). For all patient groups a guarantee of continuous and adequate analgesia (avoidance of fear and increasing patient compliance), exploiting suitable regional anesthesia or regional analgesia procedures when possible, and prevention of a physical opioid withdrawal syndrome have utmost priority...
July 2010: Der Anaesthesist
A Naderi-Heiden, A Naderi, M M Naderi, F Rahmani-Didar, A-R Salimi, A Gleiss, S Kasper, R Frey
INTRODUCTION: The aim of this retrospective study was to assess ultra-rapid opiate detoxification (UROD) and to estimate the retention rate in naltrexone maintenance treatment. METHODS: 45 opiate-addicted male patients (DSM-IV 304.00; opiate per oral or per inhalation n=40, heroin intravenous n=5; concomitant cannabis abuse n=6) were detoxified by 6 h of naloxone infusion under general anesthesia with midazolam, propofol, clonidine and atracurium. Withdrawal signs were evaluated by the objective opiate withdrawal scale (OOWS, range 0-13) up to 24 h after awakening...
June 2010: Pharmacopsychiatry
Philippe Richebé, Pierre Beaulieu
PURPOSE: The objective of this continuing professional development module is to describe the perioperative anesthesia and pain management of patients taking opioids because of chronic pain or drug addiction. PRINCIPAL FINDINGS: The number of patients under opioid treatment is increasing. Pain management is problematic in these patients, because regular opioid intake is associated with mechanisms of tolerance and dependence. More recently, opioid-induced hyperalgesia phenomena have been brought to light...
December 2009: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Rong-Jun Zhang, Xiao-Ge Song, Xing-Hui Cai
OBJECTIVE: To observe the effect of acupuncture and moxibustion on the conditional position preference (CPP) and prefrontal cortical ultrastructure in heroin re-addicted rats. METHODS: Thirty-two Wistar rats were randomly divided into normal, model, medication and acu-moxibustion (acu-moxi) groups, with 8 cases in each. Re-addiction model was established by repeated intramuscular injection of heroin into the hindlimbs. Rats of medication group were treated with intragastric administration of Methadone during detoxification...
April 2009: Zhen Ci Yan Jiu, Acupuncture Research
Boukje A G Dijkstra, Paul F M Krabbe, Truus G M Riezebos, Cees P F van der Staak, Cor A J De Jong
AIM: To evaluate the psychometric properties of the Dutch version of the 16-item Subjective Opiate Withdrawal Scale (SOWS). The SOWS measures withdrawal symptoms at the time of assessment. METHODS: The Dutch SOWS was repeatedly administered to a sample of 272 opioid-dependent inpatients of four addiction treatment centers during rapid detoxification with or without general anesthesia. Examination of the psychometric properties of the SOWS included exploratory factor analysis, internal consistency, test-retest reliability, and criterion validity...
2007: European Addiction Research
Joy L Steadman, David J Birnbach
PURPOSE OF REVIEW: Drug abuse, especially with designer drugs, continues to grow, involving a wide demographic range. Consequently, anesthesiologists may be involved in the care of patients under the acute and chronic influence of a myriad of substances. In addition to the usual physiological damage to vital organs (heart, lungs, kidneys, and immune system) new evidence of permanent damage in regions of the brain responsible for memory and pain mediation is emerging. As drug use continues to increase, anesthesiologists must learn to detect drug abusing patients and avoid known interactions...
April 2003: Current Opinion in Anaesthesiology
J Jage, F Heid
Addicts have an exaggerated organic and psychological comorbidity and in cases of major operations or polytrauma they are classified as high-risk patients. Additional perioperative problems are a higher analgetics requirement, craving, physical and/or psychological withdrawal symptoms, hyperalgesia and tolerance. However, the clinical expression depends on the substance abused. For a better understanding of the necessary perioperative measures, it is helpful to classify the substances into central nervous system depressors (e...
June 2006: Der Anaesthesist
A Kozian, T Schilling, T Tiede, C Huth, T Hachenberg
A 24-year-old female with a history of former heroin addiction underwent open heart surgery for a mechanical tricuspid valve replacement. Anaesthesiological management included a thoracic epidural catheter at the Th(2)/Th(3) segments and balanced general anaesthesia (remifentanil, desflurane/propofol). Additionally, clonidine (2 microg*kg(-1)*h(-1)) was continuously administered. Pain therapy was achieved using 0.375% ropivacaine via a thoracic epidural catheter (4 ml*h(-1)) and metamizole (4 x 1 g/day) intravenously...
June 2005: Der Anaesthesist
Fatemeh N Rafsanjani, Fatemeh Maghouli, Jalal Vahedian, Farzaneh Esmaeili
OBJECTIVE: Addiction to opium and heroin is not only an important social and individual problem in the world but it also affects the human physiology and multiple systems. The aim of this study is to determine the effects of chronic heroin consumption on basal and vagus electrical-stimulated total gastric acid and pepsin secretion in rats. METHODS: The study was carried out in the Department of Physiology, Kerman University of Medical Sciences, Iran from August 2002 to June 2003...
October 2004: Saudi Medical Journal
Paul F M Krabbe, Jeroen P F Koning, Nadia Heinen, Robert J F Laheij, R M Victory van Cauter, Cor A J De Jong
The aim of this work was to study abstinence rates and withdrawal effects of rapid detoxification of opioid-dependents under general anaesthesia (RD-GA) compared to standard methadone tapering (SMT) using a prospective clinical trial with a follow-up of 3 months, as a preliminary study at the Novadic addiction centre in St Oedenrode and St Joseph Hospital in Veghel, the Netherlands. Thirty opioid-dependent patients took part. Outcome measures included urine toxicology screening for opiates to determine abstinence and presence of objective and subjective opioid withdrawal distress symptoms...
September 2003: Addiction Biology
E Pinto, J Reggers, M Delhez, S Fuchs, I Venneman, M Lamy, M Ansseau
Many studies support the hypothesis of a substantial benefit in inducing an Opiate Receptor Blockade through a Rapid Opiate Detoxification under general Anaesthesia (RODA) in opiate dependent patients. However, prospective studies and long term evaluation of the technique are lacking. In order to evaluate long-term abstinence rates after a RODA among a sample of opiate addicts, a study was started in March 1999 at the University of Liège. To date, 45 patients were evaluated (mean age: 29 +/- 5 years) with a mean opiate dependence duration of 8 +/- 4 years...
August 2001: Revue Médicale de Liège
M Hensel, W J Kox
BACKGROUND: In the present study a method of rapid opiate detoxification under general anaesthesia has been evaluated regarding the safety, the efficacy in preventing withdrawal symptoms, and the long-term results. In addition, it was investigated whether the profile and severity of withdrawal symptoms depend on the type of opiate abused (methadone, heroin, codeine, morphine). METHODS: Seventy-two opiate addicts were detoxified in an intensive care unit (ICU). Anaesthesia was induced and maintained using propofol infusion...
March 2000: Acta Anaesthesiologica Scandinavica
A W Gotta, G F Koorbusch, C A Sullivan
No abstract text is available yet for this article.
July 1977: Journal of Hospital Dental Practice
R Pfab, C Hirtl, T Zilker
INTRODUCTION: The new technique for opiate detoxification using anesthesia and high, repetitive doses of opiate-antagonists claims to detoxify addicts without withdrawal symptoms within 24-48 hours. We studied the method with 12 opiate addicts (5 L-polamidone, 4 dihydrocodeine, 3 heroin), using general anesthesia and the antagonists naloxone 0.5 mg/kg and naltrexone > 150 mg. Objective and subjective withdrawal symptoms were measured until urine was free of drugs and patients had no withdrawal symptoms...
1999: Journal of Toxicology. Clinical Toxicology
C Dyer
No abstract text is available yet for this article.
January 17, 1998: BMJ: British Medical Journal
M Carpentier
What are we talking about when we speak of pain in a drug abuser? Physical and psychiatric pain are confounded. Heroin anesthesizes pain in general and grief pain in particular. Is there a relationship between stomatology and pain? A drug abuser's psychopathology evolves over time. The biological effects of morphine, compared with the biological effects of subutex and methadone, are sufficient in themselves to justify their use in substitution therapy. But in practice, the psychopathological situation of the drug abuser requires us to construct a close rigorous relationship to maintain treatment...
August 1997: Revue de Stomatologie et de Chirurgie Maxillo-faciale
S Mayor
No abstract text is available yet for this article.
May 10, 1997: BMJ: British Medical Journal
C Gomar, M Luis, M A Nalda
A case is presented of a pregnant heroin addict patient, with a septic sacro-iliitis due to Staphylococcus aureus. The incidence of joint infections in heroin addicts and the difficulty of diagnosis is discussed with the potential risks of spinal or extradural anaesthesia when there is infection in joints close to the needle site. Caution is advised with patients addicted to heroin who have low back pain and may have infectious sacro-iliitis.
February 1984: Anaesthesia
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