Articles: opioid-analgesics.
-
Opioids in step III of the WHO analgesic ladder are the standard of care for treating cancer pain. However, a significant minority of patients do not benefit from therapy. Genetics might play a role in predisposing patients to a good or poor response to opioids. Here, we investigated this issue by conducting a genome-wide association study (GWAS). ⋯ This genome-wide association study on European advanced cancer patients treated with opioids identifies novel regulatory variants on chromosome 20 (near PCMTD2 and OPRL1 genes) associated with pain intensity. These findings enhance our understanding of the genetic basis of opioid response, suggesting new potential markers for opioid efficacy. The study is a significant advancement in pharmacogenomics, providing a robust dataset and new insights into the genetic factors influencing pain intensity, which could lead to personalized cancer pain management.
-
Opioids, which are widely used during surgery in perioperative settings, may cause hyperalgesia, especially when the opioid employed is remifentanil. Opioid-induced hyperalgesia may increase the length of a patient's hospital stay and negatively affect enhanced recovery after surgery and the patient's prognosis. Currently, there is no consensus on treatment strategies for remifentanil-induced postoperative hyperalgesia (RIPH). ⋯ Our results demonstrated that the upregulation of LCN2 in the ACC plays a crucial role in the occurrence of RIPH, suggesting that LCN2 potentially be a therapeutic target for alleviating RIPH.
-
Minerva anestesiologica · Dec 2024
Comparison of two approaches to quadratus lumborum block for postoperative analgesia in radical cystectomy: a randomized clinical trial.
The aim of this study was to evaluate the analgesic effects following radical cystectomy using two ultrasound guided QLB techniques: anterior and intramuscular. ⋯ Compared with QLBi, bilateral ultrasound guided QLBa provided a longer time to the first analgesic request, less postoperative opioid consumption, lower NRS at rest and on movement, and higher patients' satisfaction after radical cystectomy under general anesthesia.
-
Opioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder. Opioid use disorder prevalence may have decreased in recent years, but there are few studies on trends of opioid use disorder incidence. The objective of this study was to examine opioid use disorder incidence rates to detect population changes overall and within demographic subgroups over time. ⋯ This study found that the opioid use disorder incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) and December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.