Articles: opioid-analgesics.
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To determine whether persistent opioid use after injury is associated with subsequent long-term development of clinically recognized opioid abuse. ⋯ Nearly a quarter of patients filled an opioid prescription 3 to 6 months after discharge, and this persistent use was associated with long-term development of opioid abuse.
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Preventive medicine · Dec 2021
Impacts of prescription drug monitoring program policy changes and county opioid safety coalitions on prescribing and overdose outcomes in California, 2015-2018.
In 2015, California received funding to implement the Prescription Drug Overdose Prevention Initiative, a 4-year program to reduce deaths involving prescription opioids by 1) leveraging improvements to California's prescription drug monitoring program (PDMP) (i.e., mandatory PDMP registration for prescribers and pharmacists), and 2) supporting county opioid safety coalitions. We used statewide data from 2011 to 2018 to evaluate the Initiative's impact on opioid prescribing and overdose rates. Prescribing data were obtained from California's PDMP; fatal and non-fatal overdose data were obtained from the California Department of Public Health. ⋯ Both interventions were also associated with significantly fewer deaths involving any opioid but had no significant association with non-fatal overdose rates. Findings add to the knowledge available to guide policy to prevent high-risk prescribing and opioid overdoses. While further study is needed, coalitions and mandatory PDMP registration may be important components in such efforts.
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Randomized Controlled Trial Comparative Study
Type of anesthesia and quality of recovery in male patients undergoing lumbar surgery: a randomized trial comparing propofol-remifentanil total i.v. anesthesia with sevoflurane anesthesia.
Previous studies have shown that women achieve a better quality of postoperative recovery from total intravenous anesthesia (TIVA) than from inhalation anesthesia, but the effect of anesthesia type on recovery in male patients is unclear. This study therefore compared patient recovery between males undergoing lumbar surgery who received TIVA and those who received sevoflurane anesthesia. ⋯ This study demonstrates that the quality of recovery is not significantly different between male TLIF surgery patients who receive TIVA and those who receive sevoflurane anesthesia. Patients in the TIVA group had better postoperative analgesic effect on POD2.
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Preventive medicine · Dec 2021
Prescription opioid use among women of reproductive age in the United States: NHANES, 2003-2018.
Women are prescribed opioids more often than men. Prescription opioid use among women of reproductive age is a public health concern because opioid use during pregnancy is associated with decreased prenatal care and increased risk of adverse perinatal and maternal outcomes. Recent prevalence estimates and correlates of prescription opioid use and long-term use among women of reproductive age are limited. ⋯ Correlates of prescription opioid use and long-term use included ages 35-44, non-Hispanic White, public insurance, and women with poor or fair health status. As policy makers and clinicians strive to reduce the negative impacts of the opioid epidemic, they should consider the demographic groups most likely to use prescription opioids long-term. Additionally, reductions in opioid prescribing should be balanced with increased availability of nonopioid therapies and monitoring for opioid use disorder.
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Pediatric emergency care · Dec 2021
Factors Associated With Opioid Prescribing for Distal Upper Extremity Fractures at a Pediatric Emergency Department.
The aims of this study were to describe the prescribing patterns of oxycodone for patients with distal upper extremity fractures and to evaluate factors that influence the quantity of oxycodone prescribed at discharge. ⋯ Opioid prescribing differs based on patient- and provider-related factors. Given the variability in prescribing patterns, changing suggested opioid prescriptions in the electronic medical record may lead to more consistent practice and therefore decrease unnecessary prescribing while still ensuring adequate outpatient analgesia.