- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Journal: Opioid-induced esophageal dysfunction. (Pubmed Central) - Oct 20, 2021
OIED appears to be due to impaired inhibitory signals in the esophagus. Opioid cessation or dose reduction is recommended, but studies examining management of OIED are lacking.
- |||||||||| dexamethasone / Generic mfg.
Clinical, Journal: Preoperative high-dose Steroids in Total Knee and Hip Arthroplasty - Protocols for three randomized controlled trials. (Pubmed Central) - Oct 20, 2021
To investigate the effect of a higher than previously used dose of glucocorticoids (dexamethasone (DXM)), administered intravenously before surgery, as part of standardized fast-track regimen, on postoperative pain in TKA/THA subgroups...Predicted HPR groups consist of either PCs with PCS-score of ≥ 21 and/or history of ongoing opioid-treatment of 30 mg/day of morphine or equivalents > 30 days...Patients are completed for follow-up on day 90. Recruiting commenced February 2019 and is expected to finish September 2020.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Duration of opioid use and association with socioeconomic status, daily dose and formulation: a two-decade population study in Queensland, Australia. (Pubmed Central) - Oct 20, 2021
The risk of being dispensed prescription opioids for ≥4 months significantly increased as the dose increased: adjusted odds ratio 1.73; 95% CI, 1.71, 1.75, adjusted odds ratio 1.89; 95% CI, 1.87, 1.92, and adjusted odds ratio 3.63; 95% CI, 3.58, 3.69 for the ≥20 to <50 oral daily morphine milligram equivalent, ≥50 to <100 oral daily morphine milligram equivalent and ≥100 oral daily morphine milligram equivalent dose categories, respectively. Conclusion Higher doses and living in a low socioeconomic status areas were associated with increased risk of long-term dispensing of opioid prescriptions.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Controversial Topics in Total Knee Arthroplasty: A 5-Year Update (Part 1). (Pubmed Central) - Oct 20, 2021
By analyzing the results of the aforementioned studies, surgeons can implement the most up-to-date evidence-based care when doing total knee arthroplasty surgery. However, many of these selected topics continue to have a component of ongoing controversy with no definitive conclusions developed in recent literature.
- |||||||||| morphine sulphate / Generic mfg.
Journal: High-Risk Opioid Prescribing Trends: Prescription Drug Monitoring Program Data From 2010 to 2018. (Pubmed Central) - Oct 20, 2021
PDMPs may represent the most complete data regarding the dispensing of opioid prescriptions and as such be valuable tools to inform and monitor the supply of licit opioids. Our results indicate that public health policy, legislative action, and multiple clinical interventions aimed at reducing high rates of opioid prescribing across the health care ecosystem appear to be succeeding in the state of South Carolina.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Exploring the use of extended release opioids at shortened dosing intervals in people with chronic pain and high risk medication or substance use. (Pubmed Central) - Oct 20, 2021
This use was associated with a higher daily morphine equivalent dose (533 mg vs 236 mg, p < 0.01), use of oxycodone extended release products (50% vs. 27%, p < 0.01), a longer duration of opioid therapy (8.9 vs. 6.8 years, p = 0.03) and a diagnosis of chronic neuropathic pain (63% vs. 39%, p < 0.01), with no differences in reported pain intensities, compared with use at standard intervals...It is unlikely that of those using extended release opioids, the high proportion of use at shortened intervals is the result of inter-patient differences in metabolism alone. Further study is warranted to explore the underlying drivers and implications for people with chronic pain.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Retrospective data, Journal: Oxycodone versus other opioid analgesics after laparoscopic surgery: a meta-analysis. (Pubmed Central) - Oct 20, 2021
With the additional knowledge of therapeutic indications for drug use, UCTDA may allow for analysis of trends in illicit drug use and the impact of interventions to curb neonatal abstinence syndrome. Oxycodone is superior to other analgesics within 24 h after laparoscopic surgery, but its adverse effects should be carefully considered.
- |||||||||| duloxetine / Generic mfg.
Retrospective data, Review, Journal: Duloxetine for the reduction of opioid use in elective orthopedic surgery: a systematic review and meta-analysis. (Pubmed Central) - Oct 20, 2021
Meta-analysis revealed statistically significant [mean difference (95% CI)] lower total opioid use with duloxetine postoperatively at 24 h [- 31.9 MME (- 54.22 to - 9.6), p = 0.005], 48 h [- 30.90 MME (- 59.66 to - 2.15), p = 0.04] and overall [- 31.68 MME (- 46.62 to - 16.74), p < 0.0001]. Conclusion These results suggest that adding perioperative administration duloxetine 60 mg to a multimodal analgesia regimen within the orthopedic surgery setting significantly lowers total postoperative opioid consumption and reduces pain without significant adverse effects.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Demographic, Clinical, and Prescribing Characteristics Associated with Future Opioid Use in an Opioid-Naive Population in an Integrated Health System. (Pubmed Central) - Oct 20, 2021
Conclusion These results suggest that adding perioperative administration duloxetine 60 mg to a multimodal analgesia regimen within the orthopedic surgery setting significantly lowers total postoperative opioid consumption and reduces pain without significant adverse effects. By identifying population characteristics associated with continued opioid use following a first prescription, our data pave the way for quality improvement interventions that target individuals who are at higher risk of opioid dependence.
- |||||||||| morphine sulphate / Generic mfg., ropivacaine / Generic mfg., paracetamol / Generic mfg.
Clinical, Journal: A combination of infraclavicular and suprascapular nerve blocks for total shoulder arthroplasty: a case series. (Pubmed Central) - Oct 20, 2021
By identifying population characteristics associated with continued opioid use following a first prescription, our data pave the way for quality improvement interventions that target individuals who are at higher risk of opioid dependence. The combination of suprascapular and infraclavicular nerve block shows an encouraging postoperative analgesic profile and a low risk for hemidiaphragmatic paralysis after total shoulder arthroplasty.
- |||||||||| pregabalin / Generic mfg., gabapentin / Generic mfg.
Retrospective data, Journal: Association of gabapentinoid utilization with postoperative pulmonary complications in gynecologic surgery: a retrospective cohort study. (Pubmed Central) - Oct 20, 2021
Gabapentinoid utilization increased from 3.9% in 2015 to 12.3% in 2018, and were associated with increased pulmonary complications (OR 1.19; 95% CI 1.03 to 1.38), non-invasive ventilation (OR 1.53; 95% CI 1.29 to 1.81), duration of hospital stay (% change 1.75; 95% CI 0.92 to 2.59), daily antiemetics doses on day of surgery (MD 1.37; 95% CI 1.26 to 1.49) and subsequently (MD 1.61; 95% CI 1.30 to 1.99), and higher daily average (MD 4.59 mg; 95% CI 3.55 to 5.63) and total (MD 8.74 mg; 95% CI 6.83 to 10.62) parenteral morphine equivalents. Gabapentinoid utilization in gynecologic surgery is increasing and associated with postoperative pulmonary complications.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Review, Journal: Paracervical Block or Uterosacral Ligament Infiltration for Benign Minimally Invasive Hysterectomy: A Systematic Review and Meta-analysis. (Pubmed Central) - Oct 20, 2021
Meta-analysis pooling the results of 2 trials of uterosacral infiltration demonstrated opioid consumption of 20.73 morphine milligram equivalents less compared with controls (95% confidence interval, -23.54 to -17.91; P < 0.000)...Although a meta-analysis was unable to be performed for all studies because of lack of comparison groups or numerical data, there is evidence that preemptive uterosacral ligament infiltration may reduce postoperative pain and opioid consumption after vaginal hysterectomy. Our study does not allow us to make any substantive conclusions on the use of paracervical block in vaginal hysterectomy or the use of either type of injection in laparoscopic or robotic hysterectomy.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Review, Journal: The safety of morphine in patients with acute heart failure: A systematic review and meta-analysis. (Pubmed Central) - Oct 20, 2021
Based on current evidence, our results suggested that although morphine therapy did not significantly increase the risk of short-term death (in the hospital or within 7 days) in patients with AHF, the risk of long-term death and invasive ventilation were significantly increased. This result needs to be further confirmed by an ongoing randomized control trial.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Comparative benefits of social housing and buprenorphine on wheel running depressed by morphine withdrawal in rats. (Pubmed Central) - Oct 20, 2021
The impact of buprenorphine and social housing to reduce the effect of morphine withdrawal in rats is consistent with the use of opioid substitution therapy and psychotherapy/social support to treat opioid withdrawal in humans. These data provide further validation for the clinical relevance for the use of wheel running to assess spontaneous opioid withdrawal.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Prenatal exposure to morphine impairs attention and impulsivity in adult rats. (Pubmed Central) - Oct 20, 2021
These data provide further validation for the clinical relevance for the use of wheel running to assess spontaneous opioid withdrawal. The current findings indicate a direct causal effect of prenatal morphine exposure on inhibitory control and task learning later in life, as well as deficits in attention following morphine exposure in adulthood.
- |||||||||| morphine sulphate / Generic mfg.
Impact Of Covid 19 On The Patient Pain Experience (Sails Pavilion) - Oct 19, 2021 - Abstract #ASA2021ASA_5506;
The average pain score in 2019 on admission was 4.18 and 2.12 upon discharge. Average OME on admission was 76.2 and 78.4 on discharge.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Enhancement of morphine-induced antinociception after electroconvulsive shock in mice. (Pubmed Central) - Oct 16, 2021
We also found that the expression level of µ-opioid receptors was significantly increased after ECS administration. These results confirm previous clinical reports showing that ECT decreased the required dose of opioids in neuropathic pain patients and suggest the hypothesis that this effect of ECT works through the thalamus.
- |||||||||| betamethasone microsphere (DE-102) / Santen
Clinical, Journal: A Prospective Randomized Trial of Surgeon-Administered Intraoperative Transversus Abdominis Plane Block With Bupivacaine Against Liposomal Bupivacaine: The TINGLE Trial. (Pubmed Central) - Oct 16, 2021
These results confirm previous clinical reports showing that ECT decreased the required dose of opioids in neuropathic pain patients and suggest the hypothesis that this effect of ECT works through the thalamus. This first randomized trial comparing laparoscopic transversus abdominis plane block with liposomal bupivacaine or bupivacaine with epinephrine and dexamethasone showed that a liposomal bupivacaine block does not provide superior or extended analgesia in the era of standardized multimodal analgesia protocols.See Video Abstract at http://links.lww.com/DCR/B533.
- |||||||||| Lucemyra (lofexidine) / US WorldMeds, Stada
Review, Journal: Kratom Dependence and Treatment Options: A Comprehensive Review of the Literature. (Pubmed Central) - Oct 15, 2021
Alternative treatments for in-patient detoxification include intravenous clonidine and a combination of oral dihydrocodeine and lofexidine. We conclude by adding a note on the research gap concerning kratom dependence, which future studies should focus on.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Sex-specific transgenerational effects of morphine exposure on reward and affective behaviors. (Pubmed Central) - Oct 15, 2021
One generation later, affective behaviors were no longer altered in F2 males but F2 females from the F0 male morphine exposure buried more marbles in the MB test. In summary, early exposure to morphine in males and females causes lineage-specific inheritance of reward and affective behaviors.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Comparison between subarachnoid morphine and femoral nerve block for analgesia after knee ligament reconstruction: a randomized clinical trial (Pubmed Central) - Oct 15, 2021
Results showed that CaMKII had a role in anxiety-like behavior in the offspring of morphine-exposed parents, and changes in neuronal firing rate and c-fos level in the NAC might be involved in this process. There was no difference in the intensity of postoperative pain in patients submitted to anterior cruciate ligament reconstruction with flexor tendons under the analgesic modalities evaluated, despite the predominance of urinary retention in the M Group and motor block in the R0,375 Group.
- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Clinical, Journal: Opioid Prescribing to US Children and Young Adults in 2019. (Pubmed Central) - Oct 15, 2021
To reduce high-risk prescribing, initiatives targeting high-volume prescribers may be warranted. However, broad-based initiatives are also needed to address the large share of high-risk prescribing attributable to other prescribers.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Alteration of neuroinflammation detected by F-GE180 PET imaging in place-conditioned rats with morphine withdrawal. (Pubmed Central) - Oct 13, 2021
This is the first study to show that a rapid recovery protocol utilizing single micro-dose ITM with oral analgesics have adequate recovery, significantly better postoperative pain control and superior perioperative outcomes to traditional protocols using PCA in the AIS population following PSF.Level of Evidence: 3. In morphine-dependent rats, Neuroinflammation (NI) became more severe in the addiction-involved brain regions but remitted in the sensory-related brain regions after the administration of naloxone, and this NI induced by withdrawal was further aggravated after conditioned aversion formation thus may help to consolidate the withdrawal memory.
- |||||||||| rivaroxaban / Generic mfg., morphine sulphate / Generic mfg.
[VIRTUAL] A CLOG IN THE RV: RIGHT VENTRICULAR THROMBUS IN TRANSIT () - Oct 13, 2021 - Abstract #CHEST2021CHEST_2301;
She had been on rivaroxaban for a history of venous thromboembolism, which had been interrupted peri-procedurally for implantation of a port...She was started on a morphine infusion for relief of pain, and was transitioned to hospice shortly thereafter... The diagnosis and management of RV thrombus is challenging; further studies and guidelines are warranted.
- |||||||||| gabapentin / Generic mfg.
[VIRTUAL] COCAINE-INDUCED COMPLETE HEART BLOCK THAT WAS REVERSED BY NALOXONE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_683;
CASE PRESENTATION: 49-year-old woman with history of coronary artery disease, mechanical mitral valve, heart failure, anxiety, and depression on aspirin, warfarin, furosemide, gabapentin, citalopram, quetiapine, and clonazepampresented with 3 days history of abdominal pain, diarrhea, and vomiting...Patient was started on IV fluids, IV antibiotics for acute colitis and morphine for pain...Patient underwent permanent pacemaker placement due to persistent CHB and during the procedure, patient received fentanyl... In conclusion, naloxone might be a possible treatment for cocaine induced CHB, but further studies are required to further elicit this observed effect.
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