Articles: opioid-analgesics.
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Practice guidelines recommend urine drug monitoring (UDM) at least annually in the setting of chronic opioid therapy as an objective assessment of substance use. However, empirical evidence on who gets tested and how often testing occurs is lacking. ⋯ Although recommended for patients with chronic pain, UDM is provided less than half of the time for these patients. However, once patients received at least one UDM, they would continue to receive it on a fairly regular basis. Compared with those with chronic pain, persons diagnosed with OUD are more likely to receive UDM at a more frequent interval.
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Despite the vast literature studying the opioid crisis, sparse data describe this in the pediatric burn population. This study sought to assess patient-level characteristics and their potential effects on opioid administration in nonsurgical pediatric burn inpatients. ⋯ Nonsurgical burn patients who were older and presented with larger TBSA experienced marked increases in opioid utilization. Overall, opioid administration decreased over time.
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Despite published declines in opioid prescribing and dispensing to children in the past decade, in few studies have researchers evaluated all children in 1 state or examined changes in mean daily opioid dispensed. In this study, we evaluated changes in the rate of dispensed opioid analgesics and the mean daily opioid dispensed to persons 0 to 18 years old in 1 state over an 8-year period. ⋯ The rate of opioid analgesic prescriptions dispensed to children 0 to 18 years old in South Carolina declined by 35.6% over the years 2010-2017; however, the MME dispensed per day declined minimally, suggesting that more can be done to improve opioid prescribing and dispensing.
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J Pain Palliat Care Pharmacother · Mar 2021
ReviewRethinking Docusate's Role in Opioid-Induced Constipation: A Critical Analysis of the Evidence.
Opioid induced constipation (OIC) is a predictable and preventable adverse effect of opioid use. Docusate is often utilized for OIC prophylaxis and treatment because of its low cost, easy accessibility and tolerability. However, the costs of docusate use may not outweigh the benefits given limited reported efficacy. ⋯ The majority of guidelines or CR that endorsed the use of docusate for OIC prophylaxis or treatment did not cite primary evidence to support their recommendations. The inclusion of docusate in major guidelines and CR for OIC management is weakly evidence based, though docusate use is still widely recommended. Institutions and health care providers should consider careful evaluation of OIC protocols and/or algorithms to ensure integration of evidence-based therapy and reduce unnecessary drug use and associated costs, which may include removal of docusate.
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Randomized Controlled Trial
Changes of Opioid Consumption After Lumbar Fusion Using Ultrasound-Guided Lumbar Erector Spinae Plane Block: A Randomized Controlled Trial.
The erector spinae plane block (ESPB) is gaining popularity in lumbar fusion for postoperative pain management. ⋯ Ultrasound-guided lumbar ESPB reduces the amount of analgesics required during and after lumbar fusion and reduces the postoperative Visual Analog Scale pain score.