Journal of opioid management
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Randomized Controlled Trial
Effect of magnesium sulfate infusion on sevoflurane consumption, hemodynamics, and perioperative opioid consumption in lumbar disc surgery.
Magnesium sulphate administration was initially reported to reduce postoperative analgesic requirements. Subsequent reports, though, were inconsistent. Specifically, we tested the hypotheses that intraoperative magnesium sulfate administration reduces postoperative requirement for opioids, secondary outcomes were intraoperative muscle relaxant, sevoflurane consumptions and postoperative pain. ⋯ Intraoperative magnesium administration significantly reduced muscle relaxant and opioid requirements; more importantly, it also reduced postoperative pain and opioid use.
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Randomized Controlled Trial
Extended-release tramadol (tramadol ER) in the treatment of chronic low back pain.
This study evaluated the safety and efficacy of tramadol ER 300 mg and 200 mg versus placebo once daily in the treatment of chronic low back pain, using an open-label run-in followed by, without washout, a randomized controlled study design. ⋯ In patients who tolerated and obtained pain relief from tramadol ER, continuation of tramadol ER treatment for 12 weeks maintained pain relief more effectively than placebo. Adverse events were similar to those previously reported for tramadol ER.
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The purpose of this study is to describe the sample characteristics and methods for a study of rural medical and nonmedical prescription opioid users with a history of OxyContin use. ⋯ A large proportion of rural opioid users who reported being treated for pain also reported nonmedical use ofprescription drugs. Similarly, among the nonmedical users, half of those reported experiencing pain that interfered with their daily life. These results suggest that many rural prescription drug users are being either incorrectly or perhaps inadequately treated for chronic nonmalignant pain. Therefore, developing educational materials and training for rural physicians about pain treatment (including drug seeking behavior) is proposed.
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This study was designed to describe and compare individuals in rural Appalachia prescribed, abusing or diverting OxyContin a region with high rates of prescription medication abuse and misuse. ⋯ This study found that these groups are not distinct and in depth evaluations, including a detailed SA history, are needed to identify the pain patient at risk for abuse and/or diversion of prescribed opioids.
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Chronic noncancer pain is often undertreated. ⋯ Fentanyl TTS associated with OTFC for breakthrough pain is a feasible and effective strategy in opioid naïve patients with severe chronic nonmalignant pain.