Articles: opioid-analgesics.
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Neural tube defects are among the most frequent congenital abnormalities of the central nervous system. Progression of neural tube deficits is affected by hereditary predilection and environmental determinants. Pethidine (meperidine) is a fast and powerful opioid analgesic in U.S. Food and Drug Administration category C. There are reports about developmental anomalies due to this medication. The aim of this study was to investigate the effects of different doses of pethidine hydrochloride on neural tube development in a chick embryo model resembling the first month of vertebral growth in mammals. ⋯ We demonstrated that pethidine hydrochloride affects neuronal development in chicken embryos. The teratogenic mechanism of pethidine hydrochloride is unclear; therefore, further investigation is required.
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Perioperative opioid pain management protocols should reflect anticipated patient need. Fracture location and external fixation may be related to post-operative pain. The purpose of this study is to evaluate the impact of fracture location, articular injury, and pre-operative external fixation, and articular injury on perioperative opioid demand following definitive fixation. ⋯ Fracture location and pre-operative external fixator placement predicted perioperative opioid demand. Articular zone (pilon, plateau, and distal femur) fracture fixation was associated with the largest increases in opioid demand after lower extremity fracture fixation. Patients with these injuries may be at highest risk of extensive opioid consumption.
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Arch Orthop Trauma Surg · Jun 2021
Meta AnalysisPrevalence and risk factors for prolonged opioid use after total joint arthroplasty: a systematic review, meta-analysis, and meta-regression.
Opioids are a mainstay for pain management after total joint arthroplasty (TJA). The prevalence and risk factors for prolonged opioid use after TJA are important to understand to help slow the opioid epidemic. We aim to summarize and evaluate the prevalence and time trend of prolonged opioid use after TJA and pool its risk factors. ⋯ To our knowledge, this is the first meta-analysis determining the risk factors of prolonged opioid use and characterizing its rate and time trend in TJA. Understanding risk factors for patients with higher potential for prolonged opioids use can be used to implement appropriate management strategies, reduce unsafe opioid prescriptions, and decrease the risk of prolonged opioid use after TJA.