Articles: opioid.
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London InterCommunity Health Centre (LIHC) launched a safer opioid supply (SOS) program in 2016, where clients are prescribed pharmaceutical opioids and provided with comprehensive health and social supports. We sought to evaluate the impact of this program on health services utilization and health care costs. ⋯ Although additional research is needed, this preliminary evidence indicates that SOS programs can play an important role in the expansion of treatment and harm-reduction options available to assist people who use drugs and who are at high risk of drug poisoning.
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Objective: To describe pain assessment and analgesic management practices in patients in intensive care units (ICUs) in Australia and New Zealand. Design, setting and participants: Prospective, observational, multicentre, single-day point prevalence study conducted in Australian and New Zealand ICUs. Observational data were recorded for all adult patients admitted to an ICU without a neurological, neurosurgical or postoperative cardiac diagnosis. ⋯ Antineuropathic agents (predominantly gabapentinoids) were used in 53 patients (11%). Conclusions: Although a majority of ICU patients were frequently assessed for pain with a validated pain assessment tool, cumulative daily doses of opioids were high, and the use of multimodal adjuvant analgesia was low. Our data on current pain assessment and analgesic management practices may inform further research in this area.
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Randomized Controlled Trial
NRD.E1, an innovative non-opioid therapy for painful diabetic peripheral neuropathy - a randomised proof of concept study.
Painful diabetic peripheral neuropathy (PDPN) affects up to 26% of patients with diabetes mellitus, with major impacts on their general health and well-being. Most available drugs fail to deliver acceptable pain reduction in the majority of patients and are often poorly tolerated. NRD.E1 is a novel product that has shown anti-nociceptive preclinical effects and good tolerability in healthy volunteer studies. ⋯ NRD.E1 is a novel non-opioid therapeutic which is being developed for the treatment of PDPN. In this randomized, controlled, dose-finding, Proof of Concept study, NRD.E1 induced a clinically relevant pain reduction and it was well tolerated. Available data suggest that NRD.E1 has at least similar efficacy and better tolerability than the currently available therapies, potentially offering a promising new therapeutic option to patients with PDPN and possibly other neuropathic pain indications.
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Minerva anestesiologica · Sep 2022
Meta AnalysisEfficacy of ultrasound-guided parasternal block in adult cardiac surgery: a meta-analysis of randomized controlled trials.
Ultrasound-guided parasternal block may be an effective regional technique to reduce pain, ventilation & ICU stay after cardiac surgery.
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No review or meta-analysis exists to elucidate the efficacy and safety of quadratus lumborum block (QLB) on the pain intensity, opioid requirement, and mobilization in patients undergoing hip surgery. This systematic review and meta-analysis of randomized controlled trials were designed to compare QLB with no block or placebo (without other nerve/plexus blocks) for patients undergoing hip surgery. ⋯ There is moderate evidence that QLB employment in hip surgery produces significant reduction in pain scores and opioid consumption within 24 hours. QLB appears to be an appropriate option for postoperative analgesia after hip surgery.