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Journal: Opioid utility function: methods and implications. (Pubmed Central) - Apr 14, 2020 We argue that utility functions give clinicians the opportunity to make an informed decision when opioid analgesics are needed for pain relief, in which opioids with a positive utility function are preferred over opioids with negative functions. Furthermore, utility functions of subpopulations will give an extra insight as a utility functions measured in one subgroup (e.g., patients with postoperative pain, good opioid responders) may not be mirrored in other patient subgroups (e.g., neuropathic pain patients, poor opioid responders).
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Journal: Reasons to avoid fentanyl. (Pubmed Central) - Apr 14, 2020 Present commercially available preparations are easily tampered and nonpharmacologic fentanyl has become the major cause of opioid deaths in the United States. This state-ofthe-art review will discuss fentanyl pharmacology, utility, safety and abuse.
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Journal: Supraclavicular block vs. intravenous regional anesthesia for forearm surgery. (Pubmed Central) - Apr 10, 2020 Higher doses of fentanyl are required intraoperatively with lesser postoperative rescue analgesic requirements when SPI is used to guide intraoperative analgesia as compared to conventional analgesia technique. IVRA had shorter onset time and needed less additional anesthetics during surgery, but induced more tourniquet pain and shorter duration of postoperative analgesia than supraclavicular block when 1% lidocaine 20 mL was used for forearm surgery.
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Journal: Novel Opioids: Systematic Web Crawling Within the e-Psychonauts' Scenario. (Pubmed Central) - Apr 9, 2020 Among NPSs, the range of prescription/non-prescription opioids (fentanyl and non-fentanyl analogs) and herbal derivatives currently represents a challenge for governments and clinicians...This is a reason of concern; each of these analogs potentially presents with different toxicodynamic profiles, and there is a lack of docking, preclinical, and clinical observations. Strengthening multidisciplinary collaboration between clinicians and bioinformatics may prove useful in better assessing public health risks associated with opioids.
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[VIRTUAL] Transdermal Opioid Use among Elderly with Dementia (Room: Screen A1) - Apr 9, 2020 - Abstract #EAN2020EAN_1085; The large difference across municipalities, particular among elderly with dementia, suggests variance in how chronic pain is treated in primary care. Our study suggests that more guidance on how to treat pain in elderly with dementia is needed.
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Clinical, Journal: Effect of neuromuscular blocking agents on sedation requirements in trauma patients with an open abdomen. (Pubmed Central) - Apr 4, 2020 In trauma patients managed with DCL, higher cumulative sedative doses were administered in patients who received adjunctive NMBA, although NMBA therapy was not associated with higher cumulative propofol dose on multivariate analysis. Consideration must be given to the potential effect of sedation on delirium and awakening following DCL.
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Journal: Instrumental and chemometric analysis of opiates via gas chromatography-vacuum ultraviolet spectrophotometry (GC-VUV). (Pubmed Central) - Apr 3, 2020 This work focuses on GC-VUV analysis applied to naturally occurring (e.g., morphine), semi-synthetic (e.g., heroin), and synthetic (fentanyl) opioids as well as common adulterants and diluents (e.g., lidocaine and quinine)...Finally, three "street" heroin samples were analyzed to show "real-world" performance for forensic analyses. These samples contained adulterants such as caffeine, as well as by-products of heroin manufacture.
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Preclinical, Journal: Breathing under Anesthesia: A Key Role for the Retrotrapezoid Nucleus Revealed by Conditional Phox2b Mutant Mice. (Pubmed Central) - Apr 2, 2020 Ketamine, propofol, and fentanyl caused death by respiratory arrest in most mice with selective loss of retrotrapezoid nucleus neurons, in doses that were safe in their wild type littermates. The retrotrapezoid nucleus is critical to sustain breathing during deep anesthesia and may prove to be a pharmacologic target for this purpose.
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Journal: Barriers to accurately assessing prescription opioid misuse on surveys. (Pubmed Central) - Apr 1, 2020 Finally, a recent barrier is use of counterfeit or adulterated drugs that contain fentanyl, its analogs, or other new synthetic opioids, which can lead to underreporting of exposure. Survey researchers should consider such barriers when querying opioid misuse.
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Clinical, Journal, Heterogeneity: Demonstrating heterogeneity of treatment effects among patients: an overlooked but important step toward precision medicine. (Pubmed Central) - Mar 31, 2020 A significant treatment-by-patient interaction was found for 3 of 4 trials (p < 0.05), suggesting heterogeneity of the effect of fentanyl among different patients in each trial. Similar analyses in other therapeutic areas could identify conditions and therapies that should be investigated further for predictors of treatment response in efforts to maximize the efficiency of developing precision medicine strategies.
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Journal: Hypoxia-Ischemia and Hypothermia Independently and Interactively Affect Neuronal Pathology in Neonatal Piglets with Short-Term Recovery. (Pubmed Central) - Mar 31, 2020 Male piglets were randomized to receive HI injury or sham procedure followed by 29 h of normothermia, sustained hypothermia induced at 2 h, or hypothermia with rewarming during fentanyl-nitrous oxide anesthesia...We conclude that the efficacy of hypothermic protection after HI is region specific and that hypothermia during anesthesia in the absence of HI may be associated with neuronal injury in the developing brain. Studies examining the potential interactions between hypothermia and anesthesia, as well as with longer durations of hypothermia, are needed.
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Clinical, Journal: Influence of combined epidural anesthesia on cognitive function, inflammation and stress response in elderly liver cancer patients undergoing surgery. (Pubmed Central) - Mar 30, 2020 The anesthetic effect was observed and the arterial oxygen saturation (SaO), heart rate (HR), mean arterial pressure (MAP) and mini-mental state examination (MMSE) and cognitive function scores by cognitive abilities screening instrument (CASI) were evaluated in the patients, and their blood was drawn to detect the inflammatory factors interleukin (IL)-6, IL-1 and tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), norepinephrine and epinephrine...Overall postoperative conditions in the observation group was superior to the control group (P<0.05), with the incidence rate of cognitive disorder lower than that in the control group (P<0.05). Combined epidural anesthesia dramatically improves the postoperative conditions and cognitive function and relieve inflammatory and stress responses in the patients with a better anesthetic effect, thus holding promise for application.
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