Articles: opioid-analgesics.
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To compare outcomes after surgery between patients who were not prescribed opioids and patients who were prescribed opioids. ⋯ Patients who were not prescribed opioids after surgery had similar clinical and patient-reported outcomes as patients who were prescribed opioids. This suggests that minimizing opioids as part of routine postoperative care is unlikely to adversely affect patients.
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Meta Analysis
Prolonged Opioid Use After Lumbar Fusion Surgery: A Meta-Analysis of Prevalence and Risk Factors.
Persistent opioid utilization after spine surgery is a rising complication among both preoperatively opioid-naïve and opioid-tolerant patients. To our knowledge, this is the first meta-analysis to determine the prevalence and characterize the risk factors that predispose patients to prolonged opioid use (≥3 months) after lumbar fusion. ⋯ The high prevalence of prolonged opioid use after lumbar fusion underscores the importance of screening patients for comorbidities and implementing targeted strategies to minimize opioid misuse.
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J Pain Palliat Care Pharmacother · Dec 2022
Meta AnalysisSuperior Hypogastric Plexus Block for Pain Management Post-Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. ⋯ However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.
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Pediatr Crit Care Me · Dec 2022
Decreases in Nephrotoxic Pain Medications Are Not Associated With Increased Opioid Utilization in Critically Ill Children.
Quality improvement initiatives to decrease rates of nephrotoxic medication exposure have reduced rates of acute kidney injury (AKI) in noncritically ill children. The objective of our study was to analyze the implementation of a similar program in critically ill children and to measure important balancing measures including opioid and benzodiazepine exposure. ⋯ The NINJA intervention was efficaciously implemented in our single-center PICU. Nephrotoxic exposure is a modifiable factor that did not inadvertently increase exposure to opioids and benzodiazepines.