Articles: opioid.
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To investigate gabapentinoid utilization and association with postoperative pulmonary complications after gynecologic surgery. ⋯ Gabapentinoid utilization in gynecologic surgery is increasing and is associated with postoperative pulmonary complications.
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Best practices in opioid prescribing after elective surgery have been developed for most surgical subspecialties, including spine. However, some percentage of patients will become chronic users. ⋯ For opioid-naïve patients, surgeons can prescribe lower amounts of opioids after elective surgery for degenerative spinal disease without concern of increased need for refills.
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Safer opioid prescribing remains a crucial issue for emergency physicians. Policy statements and guidelines recommend deliberate risk assessment for likelihood of current or future opioid use disorder prior to prescribing opioids. However, the practice patterns of emergency physicians remain underreported. ⋯ Many Canadian emergency physicians make risk assessments based on gestalt rather than identifying literature-based risk factors. This conflicts with guidelines calling for routine comprehensive assessment. Further efforts should be directed towards education in optimizing risk assessment; and towards system-level initiatives such as clear local prescribing policies, electronic-systems functionality, and developing assessment tools for use in the ED.
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Treatment of acute pain after emergency department (ED) discharge remains a challenge in the opioid crisis context. Our objective was to determine the proportion of patients using opioid vs non-opioid pain medication following discharge from the ED with acute pain, and the association of type of pain medication with average pain intensity before pain medication intake and report of pain relief. ⋯ Overall, opioids appear to be effective and used as intended by the prescribing physician.
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Blunt and ballistic injuries are two common injury mechanisms encountered by orthopaedic traumatologists. However the intrinsic nature of these injures may necessitate differences in operative and post-operative care. Given the evolving opioid crisis in the medical community, considerable attention has been given to appropriate management of pain; particularly in orthopaedic patients. We sought to evaluate relative postoperative narcotic use in blunt injuries and ballistic injuries. ⋯ III.