Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialThe Effect of Nitrous Oxide Anesthesia on Early Postoperative Opioid Consumption and Pain.
Intraoperative nitrous oxide use does not improve post-operative analgesia or reduce opioid consumption.
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Reg Anesth Pain Med · Jan 2014
Characteristics of Chronic Pain Patients Who Take Opioids and Persistently Report High Pain Intensity.
The use of self-report questionnaires to detect characteristics of altered central pain processing, as seen in centralized pain disorders such as fibromyalgia, allow for the epidemiological studies of pain patients. Here, we assessed the relationship between reporting high levels of pain while taking opioids and the presence of characteristics associated with centralized pain. ⋯ Our findings suggest that patients with persistently high pain scores despite opioid therapy are more likely than those with lower levels of pain to present with characteristics associated with having centralized pain. This study cannot determine whether these characteristics were present before (fibromyalgia-like patient) or after the initiation of opioids (opioid-induced hyperalgesia). Regardless, patients with a centralized pain phenotype are thought to be less responsive to opioids and may merit alternative approaches.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialIncreases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users.
In the United States, use of oral opioid analgesics has been associated with increasing rates of addiction, abuse, and diversion. However, little is known about the recent national use of non-illicit prescription opioid analgesics (those prescribed in a physician-patient relationship), the primary source of these drugs for the general US population. Our primary objective was to examine trends in the use of prescription opioid analgesics in the United States and to identify defining characteristics of patient users of prescribed opioids from 2000 to 2010. ⋯ The use of prescription opioid analgesics among adult Americans has increased in recent years, and this increase does not seem to be associated with improvements in disability and health status among users. On a public health level, these data suggest that there may be an opportunity to reduce the prescribing of opioid analgesics without worsening of population health metrics.