Articles: opioid-analgesics.
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Journal of anesthesia · Oct 2022
Meta AnalysisDoes surgical plethysmographic index-guided analgesia affect opioid requirement and extubation time? A systematic review and meta-analysis.
This meta-analysis of all relevant clinical trials investigated surgical plethysmographic index (SPI)-guided analgesia's efficacy under general anesthesia for perioperative opioid requirement and emergence time after anesthesia. ⋯ SPI-guided analgesia under general anesthesia could enhance recovery after surgery without increasing the postoperative complication risk. However, it did not affect intraoperative opioid requirement. Notably, SPI-guided analgesia with hypnosis monitoring could effectively reduce intraoperative opioid requirement.
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Reg Anesth Pain Med · Oct 2022
Prospective cohort study on the trajectory and association of perioperative anxiety and postoperative opioid-related outcomes.
Although perioperative anxiety is common, its trajectory and influence on postoperative pain and opioid use are not well understood. We sought to examine the association and trajectory of perioperative anxiety, pain and opioid use following common surgical procedures. ⋯ Anxiety is an independent risk factor for increased pain and opioid use after surgery. Future studies examining targeted behavioral therapies to reduce anxiety during the perioperative period may positively impact postoperative pain and opioid use.
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We assessed the joint effects of back pain and mental health conditions on healthcare utilization and costs in a population-based sample of adults in Ontario. We included Ontario adult respondents of the Canadian Community Health Survey between 2003 and 2012, followed up to 2018 by linking survey data to administrative databases. Joint exposures were self-reported back pain and mental health conditions (fair/poor mental health, mood, and anxiety disorder). ⋯ There was no evidence of synergism for all-cause utilization or costs. Combined effects of back pain and mental health conditions on back pain-specific utilization or opioid prescription were greater than expected, with evidence of synergism. Health services targeting back pain and mental health conditions together may provide greater improvements in outcomes.
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J. Thorac. Cardiovasc. Surg. · Oct 2022
Randomized Controlled TrialIntramuscular stimulation as a new modality to control postthoracotomy pain: A randomized clinical trial.
Postoperative pain after thoracic surgery primarily hinders patients' mobility, decreasing the quality of life. To date, various modalities have been suggested to improve postoperative pain. However, pain alleviation still remains a challenge, resulting in continued reliance on opioids. To tackle this problem, this study introduces a needle electrical twitch obtaining intramuscular stimulation (NETOIMS) as a new effective treatment modality for postoperative pain after thoracoscopic surgery. ⋯ NETOIMS appears to be an effective modality in alleviating postoperative pain after thoracoscopic surgery, thereby reducing the reliance on opioid use.