Articles: opioid-analgesics.
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Korean J Anesthesiol · Apr 2020
Randomized Controlled TrialUltrasound guided bilateral quadratus lumborum block vs. intrathecal morphine for postoperative analgesia after cesarean section: a randomised controlled trial.
Adequate pain control after cesarean section (CS) is crucial for mothers caring for newborns, and early ambulation to avoid thromboembolism and chronic abdominal and pelvic pain. This randomized controlled trial compared the efficacy of quadratus lumborum block (QLB) and intrathecal morphine (ITM) for analgesia after CS. ⋯ QLB and ITM are effective analgesic regimens after CS. However, QLB provides better long-lasting analgesia and reduced total postoperative morphine consumption.
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Intensive care medicine · Apr 2020
Randomized Controlled Trial Multicenter StudyMethylnaltrexone for the treatment of opioid-induced constipation and gastrointestinal stasis in intensive care patients. Results from the MOTION trial.
Constipation can be a significant problem in critically unwell patients, associated with detrimental outcomes. Opioids are thought to contribute to the mechanism of bowel dysfunction. We tested if methylnaltrexone, a pure peripheral mu-opioid receptor antagonist, could reverse opioid-induced constipation. ⋯ We found no evidence to support the addition of methylnaltrexone to regular laxatives for the treatment of opioid-induced constipation in critically ill patients; however, the confidence interval was wide and a clinically important difference cannot be excluded.
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J Am Acad Orthop Surg · Apr 2020
Who Is Prescribing Opioids Preoperatively? A Survey of New Patients Presenting to Tertiary Care Adult Reconstruction Clinics.
Preoperative opioid use is detrimental to outcomes after hip and knee arthroplasty. This study aims to identify the prevalence of preoperative opioid prescriptions and the specialty and practice setting of the prescriber, as well as the percentage of patients who do not report their opioid prescriptions and any variables associated with preoperative opioid prescriptions. ⋯ Level III, retrospective cohort study.
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In 2017, almost 4000 Canadians died from opioid-related causes. Coadministration of opioids and benzodiazepines is a risk factor for overdose. Few studies have evaluated leveraging pharmacists to address opioid-benzodiazepine coprescribing. ⋯ At the control clinic, it decreased 4% from 10.8 MDE to 10.4 MDE. A proactive, pharmacist-led intervention for coprescribed patients increased opioid tapers and decreased opioid and benzodiazepine doses. Future work will help us understand whether sustaining the intervention ultimately reduces rates of opioid-benzodiazepine coprescribing.