Neurosurgery
-
Randomized Controlled Trial
The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery - A Prospective, Randomized, Double-Blind Study.
Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. ⋯ This study shows that the perioperative use of alvimopan significantly reduced the time to return of bowel function with no increase in postoperative opioid use despite a slight increase in pain scores.
-
Peripheral nerve injuries (PNIs) of the lower extremities have been assessed in small cohort studies; however, the actual incidence, national trends, comorbidities, and cost of care in lower extremity PNI are not defined. Lack of sufficient data limits discussion on national policies, payors, and other aspects fundamental to the delivery of care in the US. ⋯ These data describe associations in the treatment of lower extremity PNIs, which are important for considering national policies, costs, research and the delivery of care.