Articles: analgesics.
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Am J Obstet Gynecol MFM · Jan 2021
Randomized Controlled TrialEnhanced discharge counseling to reduce outpatient opioid use after cesarean delivery: a randomized clinical trial.
Strategies to curb overprescribing have focused primarily on the prescriber as the point of intervention. Less is known about how to empower patients to use fewer opioids and decrease the quantity of leftover opioids. Previous studies in nonobstetrical populations suggest that patient counseling about appropriate opioid use improves disposal of unused opioids and overall knowledge about opioid use. Less is known about whether counseling reduces opioid use after hospital discharge. ⋯ Enhanced discharge opioid counseling doubled the frequency of participants reporting proper opioid disposal and improved overall knowledge about the risks associated with opioids. This intervention did not decrease opioid use in a population of women with low overall opioid use. These findings highlight possible methods to intervene on the short-term (misuse and diversion) and long-term (persistent opioid use) consequences of overprescribing.
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Randomized Controlled Trial
Effects of different epidural initiation volumes on postoperative analgesia in cesarean section.
The aim of this study was to compare the effects of different epidural initiation volumes on postoperative pain scores, analgesic requirements, and side effects in pregnant women administered patient-controlled epidural analgesia (PCEA) for postoperative pain after cesarean sections. ⋯ The PCEA initiations with different volumes provided similar pain scores. However, the 20 mL volume resulted in a lower analgesic dose requirement during the early postoperative period, and it also delayed the requirement for analgesia.
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Randomized Controlled Trial
Impact of a managed controlled-opioid prescription monitoring program on care coordination.
Inappropriate opioid medication utilization has grown tremendously in recent years. Managed care organizations have the opportunity to identify potential opioid misuse and implement care coordination interventions. ⋯ This intervention provided action-able information to prescribers regarding member opioid utilization, in addition to available managed care resources. It resulted in significantly greater reductions in the number of prescribers, pharmacies, and prescriptions compared with a general information letter notifying prescribers of available managed care resources. Implementation of this intervention has the potential to enhance coordination of care for members potentially at risk for poor health outcomes.
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Randomized Controlled Trial
Comparison of dexmedetomidine-propofol and ketamine-propofol administration during sedation-guided upper gastrointestinal system endoscopy.
Dexmedetomidine and ketamine popular sedative agents that result in minimal respiratory depression and the presence of analgesic activity. We aimed to compare the effectiveness and safety of a dexmedetomidine-propofol combination and a ketamine-propofol combination during upper gastrointestinal system endoscopy. ⋯ Dexmedetomidine-propofol and ketamine-propofol combinations may be suitable and safe for endoscopy sedation due to their different properties. It was observed that the dexmedetomidine-propfol combination was superior in terms of sedation depth and that the ketamine-propofol combination was superior in terms of early recovery. As a result, we suggest the dexmedetomidine-propofol combination for upper gastrointestinal system endoscopy sedation due to hemodynamic stability and minimal adverse effects.
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Emerg Med Australas · Dec 2020
Randomized Controlled TrialEffect of personalised, mobile-accessible discharge instructions for patients leaving the emergency department: A randomised controlled trial.
This pilot study assessed the efficacy of personalised, printed and mobile-accessible discharge instructions for pain relief for patients discharged from the ED. ⋯ Patients who received personalised printed and mobile-accessible ED discharge instructions for pain relief reported higher levels of satisfaction with their instructions, had better recall of their pain relief medications advice and received more information on medication side-effects.