Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial Multicenter Study
Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial.
To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA). ⋯ Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.
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To assess the process and outcomes of academic detailing to enhance the Opioid Safety Initiative and the Psychotropic Drug Safety Initiative to reduce co-prescribing of opioid-benzodiazepine combinations in veterans. ⋯ Stations that implemented academic detailing and had a higher proportion of providers who were exposed to opioid- or benzodiazepine-related academic detailing had a significant decrease in the monthly prevalence of Veterans co-prescribed opioid-benzodiazepine combinations.
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Meta Analysis
Pain Induced Changes in Brain Oxyhemoglobin: A Systematic Review and Meta-Analysis of Functional NIRS Studies.
Neuroimaging studies show that nociceptive stimuli elicit responses in an extensive cortical network. Functional near-infrared spectroscopy (fNIRS) allows for functional assessment of changes in oxyhemoglobin (HbO), an indirect index for cortical activity. Unlike functional magnetic resonance imaging (fMRI), fNIRS is portable, relatively inexpensive, and allows subjects greater function. No systematic review or meta-analysis has drawn together the data from existing literature of fNIRS studies on the effects of experimental pain on oxyhemoglobin changes in the superficial areas of the brain. ⋯ Pain affects the prefrontal and sensory-motor cortices of the brain and can be measured using fNIRS. Implications of this study may lead to a simple and readily accessible objective measure of pain.