Articles: analgesics.
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Randomized Controlled Trial Multicenter Study
Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery.
Postoperative pain can cause serious adverse reactions that severely affect postoperative outcome. The present study evaluated the effect of dexmedetomidine (DEX) added to sufentanil in intravenous patient-controlled analgesia (PCA) on the relief of pain and inflammatory responses during postoperative recovery of patients undergoing a combined thoracoscopic-laparoscopic esophagectomy (TLE). ⋯ Patients receiving DEX in addition to IV PCA sufentanil for TLE exhibited better postoperative analgesia, fewer inflammatory responses and lower postoperative delirium categories and better health statuses.
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Multicenter Study
Quantifying the use of opioids in the immediate postoperative period after endoscopic sinus surgery.
The opioid crisis is a public health emergency. There is limited evidence regarding how much opioid medication is necessary and which patients will require additional pain medication following endoscopic sinus surgery (ESS). The objective of this study was to quantify the use of opioids in the first 24 hours following ESS and determine the risk factors associated with increased need for opioid analgesia. ⋯ 4 Laryngoscope, 130:1122-1127, 2020.
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Gynecologic oncology · May 2020
Multicenter StudyOutcomes and patient perspectives following implementation of tiered opioid prescription guidelines in gynecologic surgery.
To report the impact of implementing standardized guidelines for opioid prescriptions after gynecologic surgery and describe patient perspectives before and after implementation for those undergoing laparotomy for ovarian cancer. ⋯ Reducing prescribed opioids after gynecologic surgery using tiered guidelines did not increase opioid refills or worsen patients' perceptions of postoperative pain. Even after laparotomy, very little opioids were required over a short duration after dismissal. Infrequent disposal of leftover opioids highlights the need to avoid over-prescribing.
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Intensive care medicine · Apr 2020
Randomized Controlled Trial Multicenter StudyMethylnaltrexone for the treatment of opioid-induced constipation and gastrointestinal stasis in intensive care patients. Results from the MOTION trial.
Constipation can be a significant problem in critically unwell patients, associated with detrimental outcomes. Opioids are thought to contribute to the mechanism of bowel dysfunction. We tested if methylnaltrexone, a pure peripheral mu-opioid receptor antagonist, could reverse opioid-induced constipation. ⋯ We found no evidence to support the addition of methylnaltrexone to regular laxatives for the treatment of opioid-induced constipation in critically ill patients; however, the confidence interval was wide and a clinically important difference cannot be excluded.