Articles: opioid-analgesics.
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The COVID-19 ARDS appears to have worse outcomes than ARDS from other causes. It is a predictable serious complication and the key strategy is to maintain oxygenation. ⋯ Cough and myalgia are the common and most distressing symptoms seen in conscious COVID-19 patients which can impair tolerance to awake proning. Modified awake proning with application of transdermal fentanyl patch (TFP) can improve the compliance to conscious proning in COVID-19 patients.
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Drug Alcohol Depend · Jul 2020
Comparative StudyRacial/ethnic differences in opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States, 1999-2017.
From 1999 to 2017, more than 400,000 Americans died from a drug overdose death involving an opioid. Early surveillance studies have observed large variations in opioid-involved overdose deaths among different geographic regions and racial/ethnic groups. The purpose of this study was to characterize trends in racial/ethnic opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States from 1999 to 2017. ⋯ The variations in opioid-involved overdose deaths among different racial/ethnic groups across geographic regions support the existence of multiple sub-epidemics in the current opioid overdose crisis and provide directions for targeted intervention efforts.
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Aliment. Pharmacol. Ther. · Jul 2020
Meta AnalysisSystematic review with meta-analysis: efficacy and safety of treatments for opioid-induced constipation.
When opioid-induced constipation is treated with centrally acting opioid antagonists, there may be opioid withdrawal or aggravation of pain due to inhibition of μ-opioid analgesia. This led to the development of peripherally acting μ-opioid receptor antagonists (PAMORAs). ⋯ Therapeutic response in opioid-induced constipation is best achieved with the PAMORAs, methylnaltrexone, naloxegol and naldemidine, which are associated with low risk of serious adverse events.
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Trauma remains one of the largest problems that the global healthcare system faces today. In the United States it remains the leading cause of death for young and middle-aged patients, and its economic burden in direct cost and loss of productivity is tremendous. ⋯ The purpose of this review is to summarize the current state of pain control and opioid use in acute orthopaedic injury and provide an understanding of the role of PNB to improve pain management. Finally, this review provides a specific diagnosis-based treatment guideline for the use of PNB in acute orthopaedic injury.
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Multimodal analgesia regimens have been suggested to improve pain control and reduce opioid consumption after surgery. ⋯ Implementation of an evidence-based, multimodal analgesia protocol improved postoperative outcomes, including pain scores, opioid consumption, and length of hospital stay, after posterior lumbar spinal fusion.