Articles: opioid-analgesics.
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Objective: The article that follows is purposed at demonstrating how IT opioid plus bupivacaine achieves sustained acceptable pain relief while simultaneously rapidly reducing oral morphine equivalents (OME). Background: Cancer patients represent a population with significant morbidity, pain, and limited life expectancy. It is, therefore, vital to achieve satisfactory analgesia quickly and safely. ⋯ Median time to discharge was 6.5 days. Unfortunately, due to malignant mortality, 27 patients did not make it to the 6-month postoperative time point. Discussion: IDDSs with opioid plus bupivacaine represent a safe and efficient route toward expeditious pain relief and decreased OMEs in the cancer pain population.
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Observational Study
Patient Factors Associated with Opioid Consumption in the Month Following Major Surgery.
The aim of this study was to determine preoperative patient characteristics associated with postoperative outpatient opioid use and assess the frequency of postoperative opioid overprescribing. ⋯ In this prospective cohort of opioid-naïve patients undergoing major surgery, we found a number of characteristics associated with greater opioid use in the first month after surgery. Future studies should address the use of non-opioid medications and behavioral therapies in the perioperative period for these higher risk patients.
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Comparative Study
Prescribing practices of migraine-specific pharmacotherapy associated with emergency department use for migraine.
This study compared migraine medication prescribing between patients with a migraine diagnosis who used versus did not use the emergency department (ED) for migraine. ⋯ Triptan prescribing did not differ between ED utilizers and non-ED utilizers for migraine. Overall, less than half of the total patient population had a triptan prescribed. More ED utilizers had neurology referrals, prescriptions for opioids and preventive therapies, and a history of previous ED visit for any reason, which may be markers for higher disease severity or behavior patterns. Future research and interventions to reduce migraine-related ED use could target high-risk patients such as those with previous ED visits for any indication and neurology referrals.
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Prior research has demonstrated that physician desire to optimize patient satisfaction is a cause of over-prescription of opioid medications in the healthcare setting. The purpose of this study was to investigate what effect, if any, decreased opioid prescribing following arthroscopic meniscectomy had on Press-Ganey (PG) satisfaction survey scores. ⋯ A reduction in opioids prescribed after arthroscopic meniscectomy was not associated with any difference in patient satisfaction with pain management, as measured by the Press-Ganey survey. LOE: 3.