Articles: opioid-analgesics.
-
Plast. Reconstr. Surg. · Mar 2020
Case ReportsQuantifying the Crisis: Opioid-Related Adverse Events in Outpatient Ambulatory Plastic Surgery.
The United States is currently in the midst of an opioid epidemic precipitated, in part, by the excessive outpatient supply of opioid pain medications. Accordingly, this epidemic has necessitated evaluation of practice and prescription patterns among surgical specialties. The purpose of this study was to quantify opioid-related adverse events in ambulatory plastic surgery. ⋯ Opioid-related adverse events are notable occurrences in ambulatory plastic surgery. Several adverse events may have been prevented had different diligent medication prescription practices been performed. Currently, there is more advocacy supporting sparing opioid medications when possible through multimodal anesthetic techniques, education of patients on the risks and harms of opioid use and misuse, and the development of societal guidance regarding ambulatory surgery prescription practices.
-
Sleep is an evolutionarily conserved process and is important for rest and recovery of various biological functions. Sleep and alertness alterations, function as contributing/modulatory factors in initiating and maintaining drug and alcohol abuse and as factors that increase the risk for relapse. ⋯ Sleep disturbances are seen even among patients on opioid substitution therapy (OST). The aim of this review is to present an overview of sleep problems in opioid dependent patients and to delineate factors associated with sleep disturbance.
-
Prescribing limits are one policy strategy to reduce short-term opioid prescribing, but there is limited evidence of their impact. ⋯ Implementation of a prescribing limit and EMR alert was associated with an approximately 22% greater decrease in opioid dose per new prescription in NJ compared with controls in PA. The combination of prescribing limits and alerts may be an effective strategy to influence prescriber behavior.
-
Haloperidol and ketorolac have been recommended as therapies that may decrease opioid use for treatment of pain in emergency department patients. The objective of our study is to determine if administration of haloperidol or ketorolac is associated with lower use of i.v. opioids for patients with non-specific abdominal pain. ⋯ Haloperidol was not associated with decreased i.v. opioid use. Ketorolac was associated with a modest decrease in i.v. opioid use. Providers should consider the use of haloperidol and ketorolac as potentially beneficial in some cases, but there is a need for high quality studies before they can be recommended as standard therapy.