- |||||||||| morphine sulphate / Generic mfg.
Journal: Epidemiology of Opioid Prescribing After Discharge From Surgical Procedures Among Adults. (Pubmed Central) - Jun 26, 2024
The total amount of opioids dispensed within 3 days of discharge from surgery across all procedures in the sample, as measured in morphine milligram equivalents (MMEs), was calculated...These findings suggest that the optimal design and targeting of surgical opioid stewardship initiatives in adults undergoing surgery should focus on the procedures that account for the most opioid dispensed following surgery over the life span, such as childbirth and orthopedic procedures. Going forward, systems that provide periodic surveillance of opioid prescribing and associated harms can direct quality improvement initiatives to reduce opioid-related morbidity and mortality.
- |||||||||| Dynastat (parecoxib) / Pfizer
A Four-Year-Old Child Scheduled for Elective Outpatient Adenotonsillectomy: Avoiding the Pitfalls (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3251;
In the future, larger RCTs using standardized methods and assessing both short-term and long-term analgesic effects of ketamine are necessary to deepen the understanding of the issue. Case continuation: After the usual monitors are applied you proceed with a sevoflurane inhalation induction and you notice that the patient
- |||||||||| morphine sulphate / Generic mfg.
Symptomatic Catheter Tip Granuloma in a Patient With High Dose Intrathecal Morphine Therapy: To Explant or Not to Explant (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3143;
Only three drugs (morphine, baclofen, and ziconotide) are approved by the US Food and Drug Administration (FDA) for use in intrathecal pain pump, but several drugs are used off-label, such as hydromorphone, fentanyl, sufentanyl, ketamine, clonidine, and bupivacaine...This case discusses the use of the combination of long- and short-acting oral opioids in the process of rapid weaning off intrathecal opioids in a patient with an IDDS.CASE HISTORYThe patient is a 66-year-old female with a past medical history significant for pulmonary embolism, deep venous thrombosis (on Xarelto), bipolar disorder, asthma, chronic obstructive pulmonary disease, and chronic low back pain...Her pain is well controlled with oxycontin 30 mg bid and oxycodone 15 mg tid...Will you agree?9)Why did this patient develop granuloma at the tip of intrathecal catheter in the first place? Does it relate to the content of drug or it can happen to anyone with intrathecal drug delivery?10)Your new pain fellow asked if there is anything you can do prevent formation of granuloma in other patients.1
- |||||||||| morphine sulphate / Generic mfg.
PBLD401. Symptomatic Catheter Tip Granuloma in a Patient With High Dose Intrathecal Morphine Therapy: To Explant or Not to Explant (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3142;
Does it relate to the content of drug or it can happen to anyone with intrathecal drug delivery?10)Your new pain fellow asked if there is anything you can do prevent formation of granuloma in other patients.1 DESCRIPTION This Problem-Based Learning Discussion (PBLD) aims to delve into the multifaceted challenges encountered in the field of anesthesiology and offers an engaging platform for participants to deepen their understanding of anesthesiology challenges, share clinical experiences, and collaborate towards improving patient care outcomes.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., heparin sodium injection / Generic mfg.
Pain Management Strategies in the Opioid Dependent Parturient (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3030;
Platelet count was within normal limits prior to epidural catheter removal. The patient and her infant were discharged home later the following day.
- |||||||||| morphine sulphate / Generic mfg.
Symptomatic Catheter Tip Granuloma in a Patient With High Dose Intrathecal Morphine Therapy: To Explant or Not to Explant (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3028;
Only three drugs (morphine, baclofen, and ziconotide) are approved by the US Food and Drug Administration (FDA) for use in intrathecal pain pump, but several drugs are used off-label, such as hydromorphone, fentanyl, sufentanyl, ketamine, clonidine, and bupivacaine...This case discusses the use of the combination of long- and short-acting oral opioids in the process of rapid weaning off intrathecal opioids in a patient with an IDDS.CASE HISTORYThe patient is a 66-year-old female with a past medical history significant for pulmonary embolism, deep venous thrombosis (on Xarelto), bipolar disorder, asthma, chronic obstructive pulmonary disease, and chronic low back pain...Her pain is well controlled with oxycontin 30 mg bid and oxycodone 15 mg tid...Will you agree?9)Why did this patient develop granuloma at the tip of intrathecal catheter in the first place? Does it relate to the content of drug or it can happen to anyone with intrathecal drug delivery?10)Your new pain fellow asked if there is anything you can do prevent formation of granuloma in other patients.1
- |||||||||| morphine sulphate / Generic mfg.
PBLD351. Symptomatic Catheter Tip Granuloma in a Patient With High Dose Intrathecal Morphine Therapy: To Explant or Not to Explant (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_3027;
Does it relate to the content of drug or it can happen to anyone with intrathecal drug delivery?10)Your new pain fellow asked if there is anything you can do prevent formation of granuloma in other patients.1 DESCRIPTION This Problem-Based Learning Discussion (PBLD) aims to delve into the multifaceted challenges encountered in the field of anesthesiology and offers an engaging platform for participants to deepen their understanding of anesthesiology challenges, share clinical experiences, and collaborate towards improving patient care outcomes.
- |||||||||| Zepatier (grazoprevir/elbasvir) / Merck (MSD)
Hepatectomy for a Patient With Hepatocellular Carcinoma (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_2863;
He has history of hepatitis C virus with sustained virologic response (SVR) after a course of treatment with ledipasvir/sofosbuvir, and hepatocellular carcinoma that recurred despite treatment with transarterial chemoembolization (TACE)...What is elbasvir/grazoprevir?...The nurse inquires if you need blood products for this case.7) What is your vascular access of choice?8) Will you place a central venous catheter?9) Do you need to measure central venous pressure (CVP) during the procedure?10) Does the position of the tumor alter your anesthetic plan?11) What blood products would you order for this case?You place an 18-gauge IV in the holding area and sedate the patient with 2 mg of midazolam...You perform a spinal anesthetic with 250 micrograms of preservative free morphine then perform a smooth induction of anesthesia with propofol, lidocaine, fentanyl and rocuronium. You then place an arterial line, a 16 Ga IV, and initiate maintenance of anesthesia with isoflurane.12) Will you maintain the patient with crystalloid or colloid?13) How will you manage intraoperative fluid administration?14) Should you utilize cell salvage?After nearly 2 hours of dissection, the patient
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., bupivacaine/dextrose / Generic mfg.
Inadequate Spinal Anesthesia for Elective Cesarean Section: Mechanisms and Management (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_2541;
What are the factors - including adjunct drugs and different maneuvers - that influence onset, duration, quality, and distribution of a spinal block? 7.What things, if any, should the patient be counseled to tell future anesthesiologists?
- |||||||||| morphine sulphate / Generic mfg.
Troubleshooting Opioid Withdrawal in a Patient With an Intrathecal Pump: Do You Smell a (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_2385;
He subsequently had a Sacroiliac joint (SIJ) fusion in 2008.His pain treatment history included lack of adequate pain control with multiple conservative measures, eventually leading to his First intrathecal Morphine pump placement in 2009...Intrathecal Drug delivery Systems (IDDS) have shown to be more effective and produce fewer side effects than systemic opioids5 but are not without complications.Side effects of IDDS are highly individualized and range from constipation, dysphoria, and anxiety to pump malfunction, infection, catheter granuloma, neurological deficits, filling and programing errors and catheter migration. Complications can lead to intolerance, life-threatening overdose, and withdrawal.It is vitally important for skilled and trained Pain physicians to carefully select, trial, manage, and importantly recognize the complications of IDDS - even if all testing returns as
- |||||||||| morphine sulphate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Managing Compression Fracture When No One Wants to Touch the Spine (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_2141;
He sends it back to you and suggests a morphine pump...She is sent home with hydromorphone. She calls back after one week, stating she is feeling better.14.What would you do if she calls back saying pain is back?
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., bupivacaine/dextrose / Generic mfg.
Inadequate Spinal Anesthesia for Elective Cesarean Section: Mechanisms and Management (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_1579;
What are the factors - including adjunct drugs and different maneuvers - that influence onset, duration, quality, and distribution of a spinal block? 7.What things, if any, should the patient be counseled to tell future anesthesiologists?
- |||||||||| Paxlovid (nirmatrelvir/ritonavir) / Pfizer, Lodonal (naltrexone low dose oral) / Immune Therap, Statera BioPharma, Nucynta (tapentadol) / Collegium Pharma, Grunenthal
Perioperative Pain Medicine in Multi-specialty Anesthesiology Practice for Patients With Long COVID Pain Syndrome (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_1229;
What are the indications and available preparations of buprenorphine with various route of delivery systems?10.A PACU nurse mentioned a friend had positive feedback with low dose naltrexone (LDN) as chronic pain medicine...How do opioid antagonist contribute to analgesia? Are there any scientific basis and evidence-based medicine to use LDN for long COVID pain syndrome?
- |||||||||| Paxlovid (nirmatrelvir/ritonavir) / Pfizer, Lodonal (naltrexone low dose oral) / Immune Therap, Statera BioPharma, Nucynta (tapentadol) / Collegium Pharma, Grunenthal
Perioperative Pain Medicine in Multi-specialty Anesthesiology Practice for Patients With Long COVID Pain Syndrome (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_922;
What are the indications and available preparations of buprenorphine with various route of delivery systems?10.A PACU nurse mentioned a friend had positive feedback with low dose naltrexone (LDN) as chronic pain medicine...How do opioid antagonist contribute to analgesia? Are there any scientific basis and evidence-based medicine to use LDN for long COVID pain syndrome?
- |||||||||| morphine sulphate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Managing Compression Fracture When No One Wants to Touch the Spine (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_687;
He sends it back to you and suggests a morphine pump...She is sent home with hydromorphone. She calls back after one week, stating she is feeling better.14.What would you do if she calls back saying pain is back?
- |||||||||| Zepatier (grazoprevir/elbasvir) / Merck (MSD)
Hepatectomy for a Patient With Hepatocellular Carcinoma (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_685;
He has history of hepatitis C virus with sustained virologic response (SVR) after a course of treatment with ledipasvir/sofosbuvir, and hepatocellular carcinoma that recurred despite treatment with transarterial chemoembolization (TACE)...What is elbasvir/grazoprevir?...The nurse inquires if you need blood products for this case.7) What is your vascular access of choice?8) Will you place a central venous catheter?9) Do you need to measure central venous pressure (CVP) during the procedure?10) Does the position of the tumor alter your anesthetic plan?11) What blood products would you order for this case?You place an 18-gauge IV in the holding area and sedate the patient with 2 mg of midazolam...You perform a spinal anesthetic with 250 micrograms of preservative free morphine then perform a smooth induction of anesthesia with propofol, lidocaine, fentanyl and rocuronium. You then place an arterial line, a 16 Ga IV, and initiate maintenance of anesthesia with isoflurane.12) Will you maintain the patient with crystalloid or colloid?13) How will you manage intraoperative fluid administration?14) Should you utilize cell salvage?After nearly 2 hours of dissection, the patient
- |||||||||| morphine sulphate / Generic mfg.
Troubleshooting Opioid Withdrawal in a Patient With an Intrathecal Pump: Do You Smell a (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_483;
He subsequently had a Sacroiliac joint (SIJ) fusion in 2008.His pain treatment history included lack of adequate pain control with multiple conservative measures, eventually leading to his First intrathecal Morphine pump placement in 2009...2017 Jun;20(4):405-406. PMID: 28042904.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., heparin sodium injection / Generic mfg.
Pain Management Strategies in the Opioid Dependent Parturient (126A) - Jun 25, 2024 - Abstract #ASA2024ASA_477;
Platelet count was within normal limits prior to epidural catheter removal. The patient and her infant were discharged home later the following day.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Journal: Adolescent nicotine exposure promotes adulthood opioid consumption that persists despite adverse consequences and increases the density of insular perineuronal nets. (Pubmed Central) - Jun 24, 2024
Future studies are warranted to determine the optimal dose of administering intraperitoneal lidocaine among adult patients undergoing surgery. First, we show that ANE engenders punishment resistant fentanyl self-administration in a heterogenous seeking-taking chain schedule of reinforcement at least at the tested dose of fentanyl (0.75 ?g/kg)...In a combined conditioned taste avoidance and place preference paradigm we found that ANE resulted in significant reductions in the strength of morphine-induced CTA, and a simultaneous enhancement of CPP at a higher dose that was less capable of driving reinforcement in na
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Short-term outcomes of single port robotic hysterectomy with concomitant sacrocolpopexy. (Pubmed Central) - Jun 21, 2024
Median pain score and morphine equivalents administered in PACU were low at 3 (0-7) and 3.2 (0-27) respectively...Postoperative complications included 2 (2.9%) cases of ileus/small bowel obstruction, 1 (1.4%) pelvic hematoma requiring a blood transfusion, and 1 (1.4%) umbilical hernia. The SP robotic platform is a safe and feasible platform for MIS hysterectomy and sacrocolpopexy with good short term anatomic and symptomatic outcomes.
- |||||||||| morphine sulphate / Generic mfg.
Journal: A near-infrared plasmonic biosensor for detection of morphine and codeine in biological samples based on the end-to-end assembly of modified gold nanorods. (Pubmed Central) - Jun 21, 2024
Furthermore, detection limits of 40 and 62 nM were achieved for MOR and COD, respectively, which are much lower than the cut-off level of 2000 ng mL-1 for opiates in urine samples set by the Substance and Abuse Mental Health Services Administration (SAMHSA). Eventually, as proof-of-applicability, human urine and blood serum samples spiked with MOR and COD were analyzed and excellent recoveries ranging from 94.4 to 108.9% were obtained, demonstrating the successful applicability of the designed refractive index probe in real biological specimens.
- |||||||||| morphine sulphate / Generic mfg., bupivacaine/dextrose / Generic mfg.
Trial initiation date: Evaluation of the Typical Spinal Block During Cesarean Delivery (clinicaltrials.gov) - Jun 21, 2024
P=N/A, N=250, Enrolling by invitation,
This can result in financial savings from decreased health-care encounters. Initiation date: Jan 2024 --> Jun 2024
- |||||||||| morphine sulphate / Generic mfg.
Journal: Myelin plasticity in the (Pubmed Central) - Jun 19, 2024
Genetic blockade of oligodendrogenesis dampens dopamine release dynamics in nucleus accumbens and impairs behavioural conditioning to morphine. Taken together, these findings underscore a critical role for oligodendrogenesis in reward learning and identify dopaminergic neuronal activity-regulated myelin plasticity as an important circuit modification that is required for opioid reward.
- |||||||||| dexmedetomidine / Generic mfg.
Retrospective data, Review, Journal, Surgery: Dexmedetomidine as an Adjuvant to Nerve Block for Cancer Surgery: A Systematic Review and Meta-Analysis. (Pubmed Central) - Jun 19, 2024
Using dexmedetomidine as an adjuvant to nerve blocks in cancer surgery could lower the VAS pain score and prolong the regional anesthesia duration, which would lead to a decrease in total opioid consumption and possibly contribute to fewer PONV events. Furthermore, the reports of no serious adverse events indicate its good safety profile.
- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Journal: An Overview of Opioid Prescription Patterns among Non-Opioid Users Following Emergency Department Admission. (Pubmed Central) - Jun 19, 2024
This discovery prompts a critical reassessment of tramadol's therapeutic role, considering its multifaceted nature encompassing serotonergic effects and heightened fall risks. This study advocates for a nuanced and vigilant approach to tramadol prescription, cognizant of its potential risks and therapeutic implications, and highlights the imperative of optimizing data quality and traceability within electronic health records to enhance patient care and facilitate future research endeavors.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Natural distribution, structures, synthesis, and bioactivity of hasubanan alkaloids. (Pubmed Central) - Jun 18, 2024
Their intriguing molecular architecture and potential analgesic properties have captured the interest of medicinal chemists worldwide. This review meticulously examines the natural distribution, structural characteristics, biosynthetic pathways, synthetic methodologies, and biological activities of hasubanans.
- |||||||||| morphine sulphate / Generic mfg., ketamine / Generic mfg.
Successful rapid opioid taper using non-opioid-adjuncts in a patient with fungal meningitis () - Jun 18, 2024 - Abstract #AHS2024AHS_230;
During his eight-day admission, his opioid regimen was significantly escalated from 0 to greater than 250 Oral Morphine Equivalents (OMEs), with minimal improvement in pain scores. This case highlights how opioid-sparing adjuncts, namely a low-dose ketamine infusion, were used to significantly taper opioids in severe headaches related to meningitis.
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