Journal of opioid management
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Randomized Controlled Trial Comparative Study
Comparison of efficacy between buprenorphine and tramadol in the detoxification of opioid (heroin)-dependent subjects.
Tramadol is a synthetic opiate and a centrally acting weak m-opioid receptor agonist. The potential advantages of tramadol include ease of administration, low abuse potential, and being nonscheduled. This study compared tramadol and buprenorphine for controlling withdrawal symptoms in patients with opioid dependence syndrome. ⋯ Tramadol was found to have limited detoxification efficacy in moderate to severe opioid withdrawal and substantial risk of seizures as compared to buprenorphine. Further studies are warranted to examine its efficacy in mild opioid withdrawal symptoms and its potential use in outpatient settings where its administration advantages may be valuable.
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Randomized Controlled Trial
Assessing subjective and physiologic effects following intranasal administration of a new formulation of immediate release oxycodone HCl (Oxecta™) tablets in nondependent recreational opioid users.
To evaluate the pharmacodynamic effects (subjective and physiologic) of a new formulation of immediate release oxycodone HCl (IRO-A; Oxecta™) tablets compared with immediate release oxycodone HCl (IRO; Roxicodone®) tablets when crushed and administered intranasally to nondependent recreational opioid users. ⋯ Crushed IRO-A tablets demonstrated lower scores on "drug liking," "overall drug liking," and "take drug again" than crushed IRO when administered intranasally to nondependent recreational opioid users.
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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.
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Randomized Controlled Trial
PCA-derived factors that may be predictive of postoperative pain in pediatric patients: a possible role for the PCA ratio.
No method exists to reliably predict which patients will develop severe postoperative pain. The authors hypothesized that data derived from patient-controlled analgesia (PCA) pumps (specifically the ratio of patient demands to pump deliveries) may predict which patients would develop severe pain after scoliosis repair. ⋯ Patients who developed severe postoperative pain and met the criteria for opioid rotation demonstrated significantly increased PCA ratios of demand to delivery as early as 8 hours after surgery.