Articles: opioid-analgesics.
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Reg Anesth Pain Med · Apr 2024
Tracking persistent postoperative opioid use: a proof-of-concept study demonstrating a use case for natural language processing.
Large language models have been gaining tremendous popularity since the introduction of ChatGPT in late 2022. Perioperative pain providers should leverage natural language processing (NLP) technology and explore pertinent use cases to improve patient care. One example is tracking persistent postoperative opioid use after surgery. Since much of the relevant data may be 'hidden' within unstructured clinical text, NLP models may prove to be advantageous. The primary objective of this proof-of-concept study was to demonstrate the ability of an NLP engine to review clinical notes and accurately identify patients who had persistent postoperative opioid use after major spine surgery. ⋯ Access to unstructured data within the perioperative history can contextualize patients' opioid use and provide further insight into the opioid crisis, while at the same time improve care directly at the patient level. While these goals are in reach, future work is needed to evaluate how to best implement NLP within different healthcare systems for use in clinical decision support.
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J Neurosurg Anesthesiol · Apr 2024
Randomized Controlled TrialAnalgesic Effects of Preoperative Combination of Oral Pregabalin and Intravenous Magnesium Sulfate on Postoperative Pain in Patients Undergoing Posterolateral Spinal Fusion Surgery: A 4-arm, Randomized, Double-blind, Placebo-controlled Trial.
Multimodal perioperative pain management including nonopioid analgesia is a major pillar of enhanced recovery after surgery programs. The aim of this study was to investigate the analgesic efficacy of the preoperative combination of 2 nonopioid drugs, oral pregabalin and intravenous magnesium sulfate, in patients undergoing posterolateral lumbar spinal fusion. ⋯ Preoperative administration of oral pregabalin and intravenous magnesium sulfate resulted in reduced morphine consumption and greater analgesic effect than the use of each drug individually or placebo in patients undergoing posterolateral lumbar spinal fusion.
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J. Cardiothorac. Vasc. Anesth. · Apr 2024
Preoperative Alcohol Use, Postoperative Pain, and Opioid Use After Coronary Artery Bypass Surgery.
Chronic alcohol use is associated with chronic pain and increased opioid consumption. The association between chronic alcohol use and acute postoperative pain has been studied minimally. The authors' objective was to explore the association among preoperative alcohol use, postoperative pain, and opioid consumption after coronary artery bypass grafting (CABG). ⋯ There is no apparent association among mild-to-moderate preoperative alcohol consumption and early postoperative pain and opioid use in patients who underwent CABG.
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Anesthesia and analgesia · Apr 2024
Randomized Controlled TrialVirtual Reality Distraction for Reducing Acute Postoperative Pain After Hip Arthroplasty: A Randomized Trial.
Relaxation and distraction provided by virtual reality presentations might be analgesic and reduce the need for opioid analgesia. We tested the hypothesis that a virtual reality program (AppliedVR) decreases acute postoperative pain and opioid requirements in patients recovering from hip arthroplasty. We also evaluated whether virtual reality distraction improves patient mobility and reduces the need for antiemetics. ⋯ We did not observe statistically significant or clinically meaningful reductions in average pain scores or opioid consumption. As used in our trial, virtual reality did not reduce acute postoperative pain.
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Understanding factors that explain why some women experience greater postoperative pain and consume more opioids after cesarean delivery is crucial to building an evidence base for personalized prevention. Comprehensive psychosocial assessment with validated questionnaires in the preoperative period can be time-consuming. A three-item questionnaire has shown promise as a simpler tool to be integrated into clinical practice, but its brevity may limit the ability to explain heterogeneity in psychosocial pain modulators among individuals. This study compared the explanatory ability of three models: (1) the 3-item questionnaire, (2) a 58-item questionnaire (long) including validated questionnaires (e.g., Brief Pain Inventory, Patient Reported Outcome Measurement Information System [PROMIS]) plus the 3-item questionnaire, and (3) a novel 19-item questionnaire (brief) assessing several psychosocial factors plus the 3-item questionnaire. Additionally, this study explored the utility of adding a pragmatic quantitative sensory test to models. ⋯ The brief questionnaire may be more clinically feasible than longer validated questionnaires, while still performing better and integrating a more comprehensive psychosocial assessment than the three-item questionnaire.