Articles: opioid-analgesics.
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The aim of this study was to determine whether the implementation of a structured exercise stretching routine targeted at resolving myofascial pain is effective in improving outcomes of "legacy pain" patients. ⋯ The addition of a structured stretching exercise program focusing on the resolution of the myofascial pain in the treatment of "legacy pain" patients was shown to significantly reduce and often discontinue opioid use without adversely affecting pain score or functionality.
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Journal of critical care · Apr 2022
Discharge prescribing of enteral opioids in opioid naïve patients following non-surgical intensive care: A retrospective cohort study.
To estimate the incidence of new prescription of enteral opioids on hospital discharge in opioid naïve, non-surgical, critically ill patients and evaluate the risk factors associated with such occurrence. ⋯ A significant proportion of opioid naïve non-surgical ICU survivors receive a new opioid prescription on hospital discharge.
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Concurrent use of prescription opioids with gabapentinoids may pose risks of serious drug interactions. Yet, little is known about the trends in and patient characteristics associated with concurrent opioid-gabapentinoid use among older Medicare opioid users with chronic noncancer pain. ⋯ Concurrent opioid-gabapentinoid use among older Medicare beneficiaries with chronic noncancer pain and prescription opioids has increased significantly between 2011 and 2018. Future studies are warranted to investigate the impact of concurrent use on outcomes in older patients. Interventions that reduce inappropriate concurrent use may target older patients with identified characteristics.
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J Clin Monit Comput · Apr 2022
Pupillary unrest, opioid intensity, and the impact of environmental stimulation on respiratory depression.
Opioid-induced respiratory depression (OIRD) confers significant morbidity, but its onset can be challenging to recognize. Pain or stimulation effects of conversation may mask or attenuate common clinical manifestations of OIRD. We asked whether pupillary unrest could provide an objective signal of opioid exposure, and whether this signal would be independent from the confounding influence of extrinsic stimulation. ⋯ PUAL is a consistent indicator of opioid effect, and distinguishes higher opioid concentrations independently of the stimulating effects of conversational interaction. Under equivalent opioid exposure, conversational interaction delayed the onset and minimized the severity of OIRD. Clinical trial registration: NCT04301895.