Articles: opioid-analgesics.
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Evaluate opioid prescribing before and after emergency department (ED) renal colic guideline implementation focused on multi-modal pain management. ⋯ A multimodal analgesia protocol for renal colic was associated with decreased opioid prescribing, higher rates of admission to the hospital, and a higher 7-day ED representation rate.
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Although overall rates of opioid use have been plateauing, coprescriptions of benzodiazepines and opioids have increased greatly in recent years. It is unknown whether this combination is an independent risk factor for all-cause mortality as opposed to being more frequently used by persons with a baseline elevated risk of death. ⋯ This study found a significant increase in all-cause mortality associated with benzodiazepine use with or without opioid use in comparison with SSRI use. Benzodiazepine and opioid cotreatment, in particular, was associated with a 2-fold increase in all-cause mortality even after taking into account medical comorbidities and polypharmacy burden.
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Opioid and psychotropic prescriptions are common during pregnancy. Little is known about coprescriptions of both medications in this setting. ⋯ None.
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Comparative Study
Effects of dexmedetomidine versus remifentanil on mothers and neonates during cesarean section under general anesthesia.
Dexmedetomidine and remifentanil use in obstetric general anesthesia is controversial. This study aimed to compare the effects of remifentanil and dexmedetomidine on mothers and neonates during cesarean section under general anesthesia. ⋯ During general anesthesia for cesarean section, remifentanil demonstrated better control of hemodynamic stability, while dexmedetomidine demonstrated better neonatal Apgar scores, postoperative analgesia, and decreased catecholamine release.
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Journal of women's health · Dec 2020
The MATernaL and Infant NetworK to Understand Outcomes Associated with Treatment of Opioid Use Disorder During Pregnancy (MAT-LINK): Surveillance Opportunity.
Pregnant women with opioid use disorder (OUD) are at risk of overdose, infectious diseases, and inadequate prenatal care. Additional risks include adverse pregnancy and infant outcomes, such as preterm birth and neonatal abstinence syndrome. Management and treatment of OUD during pregnancy are associated with improved maternal and infant outcomes. ⋯ Determining which OUD treatments optimize maternal and infant outcomes is challenging given the host of potential factors that affect these outcomes. The Centers for Disease Control and Prevention initiated the MATernaL and Infant NetworK to Understand Outcomes Associated with Treatment of Opioid Use Disorder during Pregnancy (MAT-LINK) to monitor more than 2000 mothers and their infants, using data collected from geographically diverse clinical sites. Information learned from MAT-LINK will inform the future management and treatment of pregnant women with OUD.