Articles: opioid-analgesics.
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Pediatric emergency care · Aug 2022
Predictors of Emergency Department Opioid Use Among Adolescents and Young Adults.
It is well established that adolescents and young adults are increasingly vulnerable to the effects of early opioid exposures, with the emergency department (ED) playing a critical role in such introduction. Our objective was to identify predictors of ED opioid administration (ED-RX) and prescribing at discharge (DC-RX) among adolescent and young adults using a machine learning approach. ⋯ Machine learning methodologies were able to identify predictors of ED-RX and DC-RX, which can be used to inform ED prescribing guidelines and risk mitigation efforts among adolescents and young adults.
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Arch Orthop Trauma Surg · Aug 2022
Regional anesthesia does not decrease inpatient or outpatient opioid demand in distal femur fracture surgery.
Regional anesthesia (RA) is sometimes used to decrease pain and opioid consumption in distal femur fractures. However, the real-world impact of RA on inpatient opioid consumption and outpatient opioid demand is not well known. The hypothesis of this study is that RA would be associated with decreased inpatient opioid consumption and outpatient opioid demand. ⋯ Level III, retrospective, therapeutic cohort study.
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Opioid prescriptions in the perioperative setting are a known risk factor for long-term opioid use and misuse. Recent initiatives in the United States to address the issue have focused on judicious prescribing patterns and quality measurement to minimize opioid dispensing. However, policy gaps have limited the effectiveness of current interventions. ⋯ Additionally, formalized clinician education regarding specific nonopioid pain management alternatives may increase utilization, as will incorporation into perioperative OSPM clinical pathways. It is also important for patients to have access to the option for multimodal OSPM in the perioperative setting without financial disincentives, which may arise in surgery-specific bundled payment models. Finally, expansion of research activities regarding clinical and cost-efficacy outcomes may help to advance use of these options, laying the groundwork for development of a broader set of quality measures reflecting utilization and outcomes of multimodal OSPM in the perioperative setting.