Articles: opioid-analgesics.
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Korean J Anesthesiol · Apr 2020
Case ReportsContinuous quadratus lumborum block as part of multimodal analgesia after total hip arthroplasty: a case report.
Commonly used epidural or systemic analgesics for pain control after hip surgery carry risk for potential adverse effects. In contrast, the quadratus lumborum block (QLB) utilizes a simple and easy fascial plane technique and provides a wide area of sensory blockade. Thus, the QLB may be beneficial as analgesia after total hip arthroplasty. ⋯ Transmuscular QLB may be a suitable option for multimodal analgesia after total hip arthroplasty.
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This updated systematic review evaluated the efficacy and safety of opioids compared with placebo for chronic osteoarthritis pain. ⋯ Within the context of randomized controlled trials (4-24 weeks), opioids provided no clinically relevant pain relief and no clinically relevant reduction in disability compared with placebo in chronic osteoarthritis pain (hip, knee). Number needed to treat for an additional dropout due to side effects was 5 (95% confidence interval 4-7). Two studies found no signals of abuse and addiction. The frequency of serious adverse events including deaths did not differ from placebo.
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Eur Arch Otorhinolaryngol · Apr 2020
Randomized Controlled TrialPostoperative analgesic efficacy of perioperative intravenous lidocaine infusion in patients undergoing septorhinoplasty: a prospective, randomized, double-blind study.
Intravenous lidocaine infusion has been used for postoperative analgesia in many surgical procedures in recent years. The aim of this randomized, double-blind study was to investigate the postoperative analgesic efficacy of perioperative intravenous lidocaine infusion in patients undergoing septorhinoplasty surgery. ⋯ We recommended the use of intravenous lidocaine infusion for intraoperatively and first postoperative hours in septorhinoplasty surgery as it reduces pain scores and the need for additional opioid use.
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Eur. J. Clin. Pharmacol. · Apr 2020
Meta AnalysisSufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia: a systematic review and meta-analysis of randomized controlled trials.
To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted. ⋯ Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials.
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Multicenter Study
Postoperative Opioid Consumption in Thoracic Surgery Patients: How Much Is Actually Used?
The objective of this initiative was to perform a prospective, multicenter survey of patients after lung resection to assess the amount of opioid medication consumed and the disposition of unused opioids to inform the development of evidence-based prescribing guidelines. ⋯ Although patients undergoing MIS lung resection used significantly less opioid medication over a shorter duration of time than did patients after thoracotomy, they had relatively more excess opioid prescription. Evidence-based, procedure-specific guidelines with tailored pain regimens should be developed and implemented to reduce the amount of postoperative opioid medication remaining in the community.