Articles: opioid.
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Randomized Controlled Trial Comparative Study
Comparison of the effect of different infusion rates of sufentanil on surgical stress index during cranial pinning in children under general anaesthesia: a randomized controlled study.
Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. ⋯ Since SSI was intended to measure the blunting effects of sufentanil towards the noxious stimulus of cranial pinning, our results suggest that SSI might not be sufficiently sensitive to monitor the nociceptive response in children.
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Substance use & misuse · Dec 2017
The Curious (Dis)Connection between the Opioid Epidemic and Crime.
Drug epidemics often bring with them an accompanying rise in crime. The heroin wave of the 1970's and crack crisis of the 1980's were each accompanied by major gun violence, including large numbers of murders and violent property crimes. The current United States opioid epidemic, however, has not been associated with either a rise in homicide or in property crime. ⋯ While the drugs-crime connection has always been far more nuanced than the way it is typically portrayed, there wasn't such a glaring disconnect between reality and mythology during the drug epidemics of the 1970's and 1980's. The mystery of the missing opioid crime explosion offers unique insight into the myths and realities of drug addiction. To explore this issue further, this commentary briefly summarizes the drugs-crime connection, contrasts the current opioid crisis with drug epidemics of the past, and provides possible explanations for the absence of an opioid-fueled crime wave.
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Addict Sci Clin Pract · Dec 2017
Screening in Trauma for Opioid Misuse Prevention (STOMP): study protocol for the development of an opioid risk screening tool for victims of injury.
Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population remain under-investigated. The current project seeks to develop and pilot the implementation of a screening tool for opioid risk at American College of Surgeons (ACS) Level I and Level II trauma centers. ⋯ Positive findings from the proposed work would lead to improved, standardized opioid risk screening practices among victims of traumatic injury. The ultimate goal of this and future work is to reduce the likelihood of opioid misuse, addiction, and related complications, such as overdose and death. Trial registration Clinicaltrials.gov registration number: NCT02861976. Date of registration: Feb 9, 2016.
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Best Pract Res Clin Anaesthesiol · Dec 2017
ReviewDo we feel pain during anesthesia? A critical review on surgery-evoked circulatory changes and pain perception.
The difficulty of defining the three so-called components of « an-esthesia » is emphasized: hypnosis, absence of movement, and adequacy of anti-nociception (intraoperative « analgesia »). Data obtained from anesthetized animals or humans delineate the activation of cardiac and vasomotor sympathetic reflex (somato-sympathetic reflex) and the cardiac parasympathetic deactivation observed following somatic stimuli. Sympathetic activation and parasympathetic deactivation are used as monitors to address the adequacy of intraoperative anti-nociception. Finally, intraoperative nociception through the administration of nonopioid analgesics vs. opioid analgesics is considered to achieve minimal postoperative side effects.
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Best Pract Res Clin Anaesthesiol · Dec 2017
ReviewOpioids, respiratory depression, and sleep-disordered breathing.
The increasing use of opioids in the perioperative period has increased opioid-associated morbidity and mortality. There is a well-established connection between opioids, sleep-disordered breathing (SDB), and respiratory depression. ⋯ More studies are required to evaluate the effective management and prevention of respiratory depression in patients with SDB. This review summarizes the current state of knowledge relating to the pathophysiology of respiratory depression by opioids and opioid-related respiratory depression and appraises the association between opioids and SDB.