Articles: opioid.
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J West Afr Coll Surg · Oct 2012
Comparison of intubating conditions with propofol suxamethonium versus propofol-LIDOCAINE.
Suxamethonium is a depolarising muscle relaxant that provides rapid, excellent intubating condition and ease of intubation. Its adverse effects has led to the search for comparable alternatives. Propofol alone provides fair intubating conditions and ease of tracheal intubation. Addition of intravenous lidocaine to propofol has been reported to enhance intubating conditions. ⋯ Laryngoscopy and endotracheal intubation are possible with appropriate doses of propofol and lidocaine, without the use of suxamethonium.
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In order to evaluate the efficacy and tolerability of oxycodone in moderate-severe cancer-related pain, we conducted a systematic review of randomized controlled trials (RCTs). Publications addressing the efficacy and tolerability of oxycodone in moderate-severe cancer-related pain were selected from the Cochrane library, PubMed, Embase and CBM databases. Data were extracted from the studies by two independent reviewers. ⋯ In addition, there were statistically significant differences between oxycodone and other strong opioids in cancer-related pain on the obvious effective rate and the overall effective rate (OR, 2.03; 95% CI, 1.40-2.95; P=0.0002; OR, 1.94; 95% CI, 1.09-3.44; P=0.02, respectively). Compared with other strong opioids, nausea and constipation occurred significantly less frequently with the use of oxycodone for cancer-related pain (OR=0.52, 95% CI=0.32-0.85, P=0.009; OR= 0.55, 95% CI= 0.35-0.87, P= 0.01; respectively). In conclusion, this meta-analysis confirms that the efficacy and tolerability of oxycodone are superior to those of other strong opioids, including morphine sulfate, codeine and tramadol, supporting its use as an opioid for cancer-related pain.
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SUMMARY The buprenorphine implant (Probuphine™, Titan Pharmaceuticals, CA, USA) is a recently developed long-acting formulation of buprenorphine, which is a partial opioid agonist that is widely used in the marketed, sublingual, daily-dose form for managing opioid addiction. The new formulation uses a novel delivery system consisting of subcutaneously implanted solid matrix 'rods' made from a mixture of ethylene vinyl acetate and buprenorphine. ⋯ The implant has not yet been approved by the US FDA. The information in this review has been gleaned from research reports, documentation in the literature, and from the author's experience treating opioid-dependent patients, and involvement in clinical research examining sublingual buprenorphine and the buprenorphine implant.
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Rainer Sabatowski qualified as anesthesiologist in 1995 and as pain specialist in 2003. He was head of a pain clinic at the University of Cologne, Germany, from 2002 to 2007. Since 2007 he has been head of the Comprehensive Pain Center at the University Hospital "Carl Gustav Carus" at the Technical University Dresden (Germany). ⋯ He has spoken at many national and international pain meetings and was scientific chair of the 8th Palliative Care Congress of the German Society of Palliative Care in Dresden in 2010. He has published over 100 papers and book chapters and is on the editorial board of several pain journals. He is also a member of the advisory board of the German IASP chapter and works in several focus groups of this pain society.