Articles: opioid-analgesics.
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To evaluate the dose trajectory of new opioid tapers and estimate the percentage of patients with sustained tapers at long-term follow-up. ⋯ In an insured and Medicare Advantage population, over two-thirds of patients who initiated opioid dose tapering sustained long-term dose reductions, and the likelihood of sustaining tapers increased substantially from 2008 to 2018.
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Historically, the receipt of prescription opioids has differed among racial groups in the United States. Research has not sufficiently explored the contribution of individual health systems to these differences by examining within-system prescription opioid receipt according to race. ⋯ Within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences. (Funded by the National Institute on Aging and the Agency for Healthcare Research and Quality.).
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Comparative Study
Local anesthetic volume in ultrasound-guided interscalene block and opioid consumption during shoulder arthroscopic surgery: A retrospective comparative study.
Interscalene block (ISB) is commonly performed for regional anesthesia in shoulder surgery. Ultrasound-guided ISB enables visualization of the local anesthetic spread and a reduction in local anesthetic volume. However, little is known about the appropriate local anesthetic dose for surgical anesthesia without sedation or general anesthesia. ⋯ Decreasing the local anesthetic volume to less than 20 mL for ultrasound-guided ISB as the sole anesthesia increases the opioid consumption during shoulder arthroscopic surgery. Local anesthetics >30 mL or increased opioid consumption with <20 mL of local anesthetics could increase the risk of cardiovascular instability intraoperatively. Our findings indicate that 24 mL of local anesthetic could be used to lower the incidence of hypotensive bradycardic events.
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Anesthesia and analgesia · Jul 2021
Randomized Controlled TrialThe Effects of Intraoperative Caffeine on Postoperative Opioid Consumption and Related Outcomes After Laparoscopic Surgery: A Randomized Controlled Trial.
Intraoperative caffeine does not reduce postoperative morphine consumption after laparoscopic abdominal surgery.
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