Journal of opioid management
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EMBEDA@ (morphine sulfate and naltrexone hydrochloride) extended-release capsules, indicated for management of chronic, moderate-to-severe pain, contain pellets of morphine sulfate with a core of sequestered naltrexone, an opioid antagonist. ⋯ Results suggest that the safety profile of EMBEDA is consistent with that of an extended-release morphine formulation. Reports of exposure to tampered product yielded either withdrawal reactions or events not typical of opioid abuse. The clinical effects of EMBEDA in the context of misuse and abuse require further clinical and epidemiological exploration.
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Case Reports
A remifentanil/ketamine sedation in surgical cancer patients having severe Parkinson's disease: two case reports.
Symptoms of Parkinson's disease are related to a progressive loss of substancia nigra's dopaminergic neurons in addition to persistent activation of N-methyl-D-aspartate receptors. In specific situations such as sedation for minor surgery, tremor and dyskinesia can be very disabling. ⋯ The patients were scheduled for elective oncological plastic surgery under sedation, for which dyskinesia and tremor needed to be quickly abolished to permit surgery. Both procedures were completed with this drug combination resulting with no major side effects.
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To describe dosing regimens and efficacy of continuous infusion hydromorphone in mechanically ventilated children. ⋯ Continuous infusion hydromorphone appears to be an effective adjunctive analgesic in mechanically ventilated children.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Tolerability and efficacy of two synergistic ratios of oral morphine and oxycodone combinations versus morphine in patients with chronic noncancer pain.
Analgesic synergy and improved tolerability have been reported for flexible dose morphine and oxycodone combinations. This report describes two studies with similar double-blind, randomized, 7-day crossover designs (up to 7 days per arm) conducted to 1) explore the analgesic and safety benefit offixed ratio of morphine (M) and oxycodone (0) combinations (MOX) and 2) define the optimal ratio for morphine and oxycodone combination. ⋯ A 3:2 or 1:2 fixed ratio combination of morphine and oxycodone (MOX) produced analgesic synergy and a tolerability profile improvement in patients with chronic noncancer pain.
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Randomized Controlled Trial
A comparative study on the effects of intrathecal morphine added to levobupivacaine for spinal anesthesia.
In this prospective, randomized, double-blind, controlled study, we investigated the sensory, motor, and analgesic block characteristics oftwo diferent doses of morphine compared with saline when added to 0.5 percent levobupivacaine. ⋯ In patients undergoing cesarean delivery with CSEA, adding intrathecal morphine (0.1 and 0.2 mg) to 15 mg of spinal levobupivacaine prolonged the duration of spinal analgesia and provided rapid onset of action and longer time to first analgesic request without causing any significant side effect compared to saline.