Pain medicine : the official journal of the American Academy of Pain Medicine
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Opioids can suppress gonadal hormone production, which may result in low testosterone levels. To date, there have been no large-scale population-based studies examining the extent to which opioid use may contribute to changes in testosterone levels. ⋯ When assessing the impact of opioids on testosterone, the effects of age and medical conditions should be considered.
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In recent years, there has been increased attention to pain management after surgery in the hospital setting along with financial enticement from the US government. The aim of this study is to evaluate the current efficacy of postoperative pain management. ⋯ The incidence of severe-to-extreme pain in patients before and after discharge following inpatient surgery is 12-13%, and this is a reduction from 10 years ago.
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To evaluate the efficacy of a lumbosacral spine phantom to improve novices' proficiency in performing ultrasound-guided facet joint injection and medial branch block. ⋯ Training using a gelatin-based spine phantom helped novices to acquire the skills necessary to perform ultrasound-guided lumbar facet joint injections and medial branch blocks.
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Randomized Controlled Trial
Comparative Analgesic Efficacy of Oxycodone/Acetaminophen vs Codeine/Acetaminophen for Short-Term Pain Management Following ED Discharge.
To test the hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen following emergency department (ED) discharge. ⋯ Our hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen was rejected. Although pain within each group was reduced by more than half, the between-group difference was not significant. Pending independent validation, these unexpected findings suggest that codeine/acetaminophen, a Schedule III agent, may be a clinically reasonable outpatient opioid alternative to oxycodone/acetaminophen, a more tightly restricted Schedule II agent thought to be more prone to misuse.
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Review
An Expedited Diagnostic Algorithm for Lumbosacral Pain: "The Best Likelihood Scenario Approach".
The logic behind diagnostic blocks is very straightforward. What has not been determined is the way diagnostic blocks can be best used. ⋯ "The Best Likelihood Scenario" might improve diagnostic accuracy while decreasing societal costs.