- |||||||||| morphine sulphate / Generic mfg.
Journal: SR-17018 Stimulates Atypical µ-Opioid Receptor Phosphorylation and Dephosphorylation. (Pubmed Central) - Sep 26, 2021 It was later shown that SR-17018 can also reverse morphine tolerance and prevent withdrawal via a hitherto unknown mechanism of action...SR-17018 exhibits a qualitative and temporal MOP phosphorylation profile that is strikingly different from any other known biased, partial, or full MOP agonist. We conclude that detailed analysis of receptor phosphorylation may provide novel insights into previously unappreciated pharmacological properties of newly synthesized MOP ligands.
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Preclinical, Journal: Individual Differences in Different Measures of Opioid Self-Administration in Rats Are Accounted for by a Single Latent Variable. (Pubmed Central) - Sep 25, 2021 The current study used FA to examine the latent factor structure of four measures of i.v. morphine self-administration (MSA) in rats (i.e., acquisition, demand elasticity, morphine/cue- and stress/cue-induced reinstatement)...However, stress/cue-induced reinstatement loaded poorly onto this factor, suggesting that unique mechanisms mediate individual differences in this vs. other MSA measures. Further establishing FA approaches in drug SA and in preclinical neuropsychopathology more broadly will provide more reliable, clinically relevant core factors underlying disease vulnerability in animal models for further genetic analyses.
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Journal: Nicotine and its metabolite cotinine target MD2 and inhibit TLR4 signaling. (Pubmed Central) - Sep 25, 2021 Neither a pan nicotinic acetylcholine receptor (nAChR) inhibitor nor RNAi for nAChRs abolished the suppressive effect of nicotine- and cotinine-induced neuroinflammation. These data indicate that TLR4 inhibition by nicotine and cotinine at the concentrations tested in BV-2 cells is independent of classic neuronal nAChRs and validate that MD2 is a direct target of nicotine and cotinine in the inhibition of innate immunity.
- |||||||||| ketorolac / Generic mfg.
[VIRTUAL] Coronary Vasospasm in a Pediatric Patient with Myopericarditis After COVID-19 Vaccine () - Sep 25, 2021 - Abstract #AAPNCE2021AAP_NCE_1232; He was admitted for suspected myopericarditis and treated with ketorolac, prednisone, and IVIG...He was started on a nitroglycerin drip, supplemental oxygen, low dose aspirin and received 3 doses of morphine... This case highlights the importance of recognizing coronary vasospasm as a potential complication of COVID vaccine-induced myopericarditis.
- |||||||||| gabapentin / Generic mfg.
[VIRTUAL] Same Day Discharge for Repair of Pectus Excavatum () - Sep 25, 2021 - Abstract #AAPNCE2021AAP_NCE_1147; The majority of patients (65%) in Group 3 were able to be discharged home on the evening of surgery. Of the six patients that were not able to go home on the same day as surgery, all were discharged the following day with no overnight complications or interventions.
- |||||||||| hydromorphone hydrochloride / Generic mfg., midazolam hydrochloride / Generic mfg.
[VIRTUAL] Hydromorphone-based Analgosedation in the PICU: A Pilot Study () - Sep 25, 2021 - Abstract #AAPNCE2021AAP_NCE_1102; This pilot study demonstrated overall improvement in short-term patient outcomes when compared to F-ASP, but due to limited power, results did not reach statistical significance. Further large-scale studies are necessary to demonstrate efficacy and long-term sustainability.
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Incorporating Intraoperative Acupuncture To Reduce Opioid Usage After Total Knee Arthroplasty: A Prospective Cohort Trial (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5349; Primary outcome data included the incidence of patients who maintained a low-dose opioid regimen defined as 15 or fewer oxycodone 5mg pills, or 112.5 oral morphine equivalents (OME) from POD0 to 30...ConclusionIn the context of the opioid epidemic, achieving low-dose perioperative opioid consumption is critical to reducing the risk of long-term opioid use. In this prospective cohort study, we present a feasible approach to integrating intraoperative electro-auricular acupuncture into an existing multimodal analgesia regimen for patients undergoing TKA to minimize post operative opioid usage.
- |||||||||| methadone / Generic mfg.
Use Of Intraoperative Methadone In Patients Undergoing Multilevel Spine Surgery (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5317; However, patients with a low preoperative opioid requirement required fewer opioids postoperatively and had lower pain scores with methadone compared to other intraoperative opioids. Furthermore, surveyed PACU nursing staff favored the use of methadone.
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24-hour Oral Morphine Equivalent Based Opioid Prescribing After Surgery (Sails Pavilion) - Sep 25, 2021 - Abstract #ASA2021ASA_5290; The impact of this quality improvement project is reflected by our findings. Yet, even at the current, more conservative level of opioid prescribing, a large proportion of leftover opioids were reported.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., epinephrine / Generic mfg.
Spinal Anesthesia In Suspected Brugada Syndrome (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5144; After an unsuccessful trial of labor, she elected for a cesarean section and received spinal anesthesia with 12mg of hyperbaric bupivacaine, 10mcg fentanyl, 150mcg morphine, and 100mcg epinephrine. She was discharged a few days later without complications.
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High Spinal Anesthesia In Active Carcinoid Syndrome For Right-sided Double Valve Replacement (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_5134; With the aim of enhanced analgesia, decreased stress response, and early recovery, high spinal anesthesia was performed by administering intrathecal 7.0 ml of 0.75% bupivacaine and 500 mcg of morphine, just prior to general anesthesia induction...No intravenous opioids were administered intraoperatively. Patient was extubated immediately after ICU admission on postoperative day 0 with adequate pain control and discharged home on postoperative day 8.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Cesarean Delivery In A Parturient With Marfan Syndrome Complicated By A Dilating Aortic Root (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4975; An elective cesarean delivery was done at 28 weeks: intrathecal fentanyl 15mcg and morphine 0.2mg were given and general anesthesia was performed with pre-induction arterial and central lines and FloTrac monitoring. Surgery and extubation were uneventful, and the patient was discharged after 6 days.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., dexmedetomidine / Generic mfg.
Extremely High Opioid Requirements In Postoperative Care (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4862; However his postoperative care was complicated by right upper quadrant pain consistent with preoperative exam. In order to manage his pain, he required in total 37.25 mg of intravenous hydromorphone, 3.1 grams of intravenous fentanyl, and 30 mg of morphine through his jejunostomy tube over the course of his 11-hour stay.
- |||||||||| Eladur (bupivacaine) / Amneal
Hypothermia Induced Bradycardia, Without Hypotension, Secondary To Spinal Anesthesia (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4649; This patient's case was complicated by symptomatic bradycardia (40s) without hypotension, likely secondary to hypothermia (94.7 F orally) from spinal anesthesia (intrathecal bupivacaine, fentanyl, and morphine). Given the patient's previous history of post-operative nausea/vomiting, and classes of medications administered during perioperative stay, the patient required a prolonged stay in the PACU prior to being transferred to Labor and Delivery and ultimately discharged home.
- |||||||||| morphine sulphate / Generic mfg.
Caesarean Section In Treacher Collins Syndrome Patient (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4612; Anesthesia was induced by combined spinal epidural with bupivacaine and morphine. Patient underwent successful C-section and epidural was removed without complication.
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Iatrogenic Opioid Withdrawal In A Ventilated Covid-19 Patient Treated With Lidocaine Infusion (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4576; The inpatient pain medicine service was consulted for assistance and the patient was initiated on a continuous lidocaine infusion for 5 days. During this time, the patient's daily oral morphine equivalents were titrated down from 1160 to 120 OME mg and she was able to participate in spontaneous breathing trials and was later successfully weaned from the ventilator.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Case Of A High Spinal In An Obese Parturient Despite Dose Reduction (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_4537; This case describes a high spinal in an obese parturient despite dose reduction, highlighting the variability of response to intrathecal dosing and elevated risk for high spinal in obese parturients. Therefore, additional intrathecal dose reductions with a catheter-based technique may be warranted in obese parturients.
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Opioid Stewardship In Orthopaedic Surgery (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_3853; The NYU Langone Orthopedic Hospital performed an analysis of physician prescribing patterns from 2016 to 2017 within the department and subsequently developed an opioid stewardship protocol with the goal of improving patient safety. After implementation of the protocol, both fraction of post-operative patients prescribed opioids and daily mean morphine equivalent prescribed was found to be reduced.
- |||||||||| gabapentin / Generic mfg.
Sphenopalatine Ganglion Block For Headache Treatment After Dural Puncture (Exhibit Hall) - Sep 25, 2021 - Abstract #ASA2021ASA_3561; After the patient's consent, we proceeded with bilateral sphenopalatine ganglion block, for 5 minutes, using cotton tipped applicators soaked in 1% ropivacaine. Ten minutes later, the patient reported total relief from previous pain.
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