Articles: opioid.
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Comparative Study
Patient controlled analgesia: The impact of an 8 versus 10 minute lockout interval in postoperative patients.
The purpose of this study was to compare the level of pain control achieved with 8 versus 10 minute lockout intervals in adult patients who received patient controlled analgesia (PCA) within 24 hours of surgery. There was no difference in pain in the first 72 hours between the 8 minute and 10 minutes group. Additionally, there was no difference in time to first PCA regimen change or a composite outcome of adverse events.
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Palliative medicine · Jul 2018
In silico (computed) modelling of doses and dosing regimens associated with morphine levels above international legal driving limits.
Morphine can cause central nervous system side effects which impair driving skills. The legal blood morphine concentration limit for driving is 20 µg/L in France/Poland/Netherlands and 80 µg/L in England/Wales. There is no guidance as to the morphine dose leading to this concentration. ⋯ This novel study provides predictions of the in silico (computed) dose-concentration relationship for international application. Individualised morphine prescribing decisions by clinicians must be informed by clinical judgement considering the individual patient's level of impairment and insight irrespective of the blood morphine concentration as people who have impaired driving will be breaking the law. Taking into account expected morphine concentrations enables improved individualised decision making.
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Opioid prescribing patterns among otolaryngologists: Crucial insights among the medicare population.
There has been growing recognition of the roles prescription drug misuse and diversion play in facilitating the ongoing opioid epidemic. Our objective was to evaluate opioid prescription patterns among practicing otolaryngologists. ⋯ NA. Laryngoscope, 128:1576-1581, 2018.
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Certain common medications are associated with an elevated risk of fracture and recent data suggests that medications can also increase nonunion risk. Medication use is a modifiable nonunion risk factor, but it is unknown whether risk accrues solely to chronic medication use or whether there is also risk inherent to acute use. ⋯ Patients evaluated in this study were not a random sample of Americans; they may approximate a random sample of the Emergency Department population in the United States. Thus, trauma patients may represent a population enriched for nonunion risk factors. Opioids impair recovery from injury; if they also predispose to injury, the ongoing opioid epidemic could presage an increase in nonunion prevalence.
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Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses. ⋯ Many patients presenting with opioid overdose have had a history of opioid overdose. Patients with opioid overdose required a highly variable dose of naloxone. Higher doses of naloxone were associated with lower age. Despite widespread availability of naloxone to consumers, a minority of patients in this study reported access to naloxone. Participants who had access to a naloxone kit stated that their frequency and dosage of opioid use did not change.