Articles: opioid.
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J Pain Palliat Care Pharmacother · Sep 2023
Buprenorphine Inductions via Transdermal Patches for Opioid Use Disorder in the Inpatient Setting.
Buprenorphine inductions traditionally require an opioid-free period due to the risk of precipitated opioid withdrawal. Hospitalized patients with opioid use disorder and concurrent acute pain may be eligible for buprenorphine therapy. However, effective buprenorphine induction strategies in this patient population have not been well established. ⋯ All seven patients completed the induction and were discharged on sublingual buprenorphine. Low dose transdermal buprenorphine provides a reasonable strategy for hospitalized patients on full agonist opioid therapy or those who have failed conventional buprenorphine induction strategies. Reducing barriers such as opioid abstinence is key to combating opioid use disorder.
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Arch Orthop Trauma Surg · Sep 2023
Observational StudyPost-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.
Optimized health system approaches to improving guideline-congruent care require evaluation of multilevel factors associated with prescribing practices and outcomes after total knee and hip arthroplasty. ⋯ In the present study, several patient-, care-, and hospital-level factors were associated with an increased probability of an opioid prescription refill within 30 days after arthroplasty. Future work is needed to identify optimal approaches to reduce unwarranted and inequitable healthcare variation within a patient-centered framework.
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The purpose of this study was to investigate the analgesic effects of duloxetine, specifically on postoperative pain, opioid consumption, and related side effects following total hip or knee arthroplasty. ⋯ Current evidence shows low to moderate opioid sparing effects of perioperative duloxetine and a statistically but not clinically significant reduction in pain scores. Patients treated with duloxetine had an increased risk for somnolence and drowsiness.