Journal of opioid management
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To examine the characteristics of postoperative fentanyl effect-site concentrations during intravenous analgesia in patients requiring or not requiring a fentanyl bolus and in patients with or without postoperative nausea and vomiting (PONV). ⋯ Patients needing a postoperative fentanyl bolus require a higher fentanyl effect-site concentration possibly because of individual variations, and PONV depends on the postoperative fentanyl effect-site concentration.
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Randomized Controlled Trial Multicenter Study
A pooled analysis of patient-specific factors and efficacy and tolerability of tapentadol extended release treatment for moderate to severe chronic pain.
To evaluate via retrospective analysis the efficacy and tolerability of tapentadol extended release (ER; 100-250 mg bid) based on patient-specific factors, including baseline pain intensity, prior opioid experience, gender, and body mass index (BMI). ⋯ Results suggest that tapentadol ER (100-250 mg bid) provides similar pain relief and tolerability, regardless of baseline pain intensity, prior opioid experience, gender, or BMI.
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Ketamine is a noncompetitive antagonist of N-methyl-d-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. ⋯ Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.
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To assess aberrant drug-related behaviors (ADRBs) in patients discharged from a community primary care practice for opioid misuse and treating physician's ability to identify predictive aberrant behaviors. ⋯ Previously postulated and novel ADRBs suggestive of opioid misuse were identified in a community primary care setting. Differences in resident and attending physician's ability to identify key predictive ADRBs and lack of training in pain or addiction underscores the need for changes in medical school and residency programs.
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This manuscript evaluates physician monitoring practices and incidence of cardiac side effects following initiation of methadone for treatment of chronic pain as compared to patients who began treatment for chronic pain with morphine sustained release (SR). ⋯ Despite recommendations for standardized assessment and cardiac risk monitoring, few patients prescribed methadone received an ECG, and this occurred at a rate that did not differ from patients prescribed morphine SR. Patients discontinued both medications at high rates. Further research is needed to evaluate the clinical significance of QTc prolongation in patients treated with methadone.