Articles: opioid-analgesics.
-
Anesthesia and analgesia · Nov 2024
Meta AnalysisDoes Nociception Level Index-Guided Opioid Administration Reduce Intraoperative Opioid Consumption? A Systematic Review and Meta-Analysis.
The nociception level (NOL) index is a quantitative parameter derived from physiological signals to measure intraoperative nociception. The aim of this systematic review and meta-analysis was to evaluate if NOL monitoring reduces intraoperative opioid use compared to conventional therapy (opioid administered at clinician discretion). ⋯ This meta-analysis does not provide evidence supporting the role of NOL monitoring in reducing intraoperative opioid consumption.
-
States have implemented policies to decrease clinically unnecessary opioid prescribing, but few studies have examined how state policies affect opioid dispensing rate trends for surgical patients. ⋯ While we observed a slight increase in the rate of Medicare beneficiaries dispensed opioids perioperatively and a substantial decrease in MMED and days' supply for those receiving opioids, state policies examined had relatively modest effects on the main measures. Our findings suggest that these state policies may have a limited impact on opioid dispensing for a patient population that is commonly dispensed opioid analgesics to help control surgical pain, and as a result may have little direct effect on clinical outcomes for this population. Changes in opioid dispensing for this population may be the result of broader societal trends than such state policies.
-
Comparative Study
Comparative Safety Analysis of Nabilone Versus Opioids: A Population-Based Cohort Study.
Some have advocated that nabilone be used rather than opioids to manage chronic, noncancer pain, since the former drug may have a better safety profile. ⋯ Ontario Ministry of Health.
-
Nationally representative rates of incident prescription opioid use in the United States adult population and selected subpopulations are unknown. Using the National Health Interview Survey (2019-2020) longitudinal cohort, a cohort with 1-year follow-up created using random cluster probability sampling of noninstitutionalized civilian U. S. adults, we estimated rates and predictors of incident opioid use. ⋯ PERSPECTIVE: This longitudinal cohort study presents nationally representative rates of incident prescription opioid use in U. S. adults and selected subpopulations. Our data suggest that some participants are using prescription opioids as a first-line or early-resort analgesic, contrary to best-practice guidelines.
-
Comparative Study
Postoperative analgesic consumption for primary versus first repeat Cesarean delivery: a historical cohort study.
It is unclear if postoperative pain experience and opioid consumption differ in patients undergoing primary vs repeat Cesarean delivery (CD) as prior studies have yielded conflicting results and none used the same patients as their own controls. We sought to compare opioid consumption and pain scores in patients undergoing both a primary and a first repeat CD, using the same patients as their own controls. ⋯ In this retrospective study, we found no differences in postoperative opioid consumption or reported pain scores in patients who underwent both a primary and a first repeat CD.