Anesthesiology and pain medicine
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Spinal cord stimulation (SCS) is an effective treatment option to relieve chronic intractable pain, and failed back surgery syndrome (FBSS) is a key indication. ⋯ This cost-consequences analysis suggests that R-SCS implants are more cost-beneficial than NR-SCS systems in well-selected patient candidates for this type of treatment.
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Opioid use disorder, a major source of morbidity and mortality globally, is regularly linked to opioids given around the time of surgery. Perioperative period, however, is markedly heterogeneous, with the diverse providers using opioids distinctively, and the various drivers of opioid misuse at-play dissimilarly, throughout the perioperative period. The risk of opioid use disorder may, therefore, be different from opioids given at the various phases of perioperative care, and the ensuing recommendations for their use may also be dissimilar. ⋯ Consequently, no firm recommendations can be extended to anesthesia providers generally managing these perioperative stages. Furthermore, with significant methodological limitations, the current recommendations for opioid use after surgery are also arbitrary. Thus, though proposals for perioperative opioid use are formulated in this article, substantive recommendations would require clear delineation of these risks, while avoiding the limitations noted in this review.