Articles: opioid-analgesics.
-
Randomized Controlled Trial Multicenter Study
Local Infiltration Analgesia With Liposomal Bupivacaine Improves Early Outcomes After Total Knee Arthroplasty: 24-Hour Data From the PILLAR Study.
Enhanced postoperative care pathways have shifted total knee arthroplasty (TKA) to outpatient and short-stay settings, placing greater emphasis on predischarge outcomes. In this study, we report prespecified secondary and tertiary end points of the PILLAR study within 24 hours after TKA in patients receiving local infiltration analgesia (LIA) with or without liposomal bupivacaine (LB). ⋯ LIA with LB 266 mg plus bupivacaine HCl significantly reduced opioid requirements and pain intensity and significantly improved discharge readiness and satisfaction 0-24 hours after TKA compared with bupivacaine HCl alone. These findings support the use of LIA with LB for TKA when early discharge is the goal.
-
Randomized Controlled Trial Comparative Study
Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: A prospective, randomized, controlled trial.
Breast cancer is the most common malignancy of women all over the world. In this study, we compared the effects of ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane (ESP) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl need of patients undergoing unilateral modified radical mastectomy surgery. ⋯ Modified PECS block reduced postoperative tramadol consumption and pain scores more effectively than ESP block after radical mastectomy surgery.
-
Reg Anesth Pain Med · May 2019
Randomized Controlled TrialImpact of patient choice for different postcesarean delivery analgesic protocols on opioid consumption: a randomized prospective clinical trial.
Choice of postcesarean delivery analgesic protocol may improve pain experience and reduce analgesic requirements. ⋯ Having a choice compared with no choice routine care did not reduce oxycodone requirements or pain scores. However, women have insight into their analgesic needs; women offered a choice and who chose the higher dose analgesic protocol required more oxycodone, and women who chose the lower dose protocol required less oxycodone. Despite providing additional analgesic (six times more intrathecal morphine plus gabapentin in high dose vs low dose protocols), we still did not equalize postcesarean oxycodone requirement differences between groups.
-
Randomized Controlled Trial Comparative Study
Pharmacokinetics of a novel, approved, 1.4-mg intranasal naloxone formulation for reversal of opioid overdose-a randomized controlled trial.
Intranasal (i.n.) naloxone is an established treatment for opioid overdose. Anyone likely to witness an overdose should have access to the antidote. We aimed to determine whether an i.n. formulation delivering 1.4 mg naloxone hydrochloride would achieve systemic exposure comparable to that of 0.8 mg intramuscular (i.m.) naloxone. ⋯ Intranasal 1.4 mg naloxone provides adequate systemic concentrations to treat opioid overdose compared with intramuscular 0.8 mg, without statistical difference on maximum plasma concentration, time to maximum plasma concentration or area under the curve. Simulations support its appropriateness both as peer administered antidote and for titration of treatment by professionals.
-
Altern Ther Health Med · May 2019
Randomized Controlled TrialThe Effects of Apotel and Remifentanil on Postoperative Pain.
One of the most common complications of a Caesarean section (C-section) is postoperative inflammation as well as operative and postoperative pain associated with the surgery. The control and mitigation of pain after surgery is the main goal of anesthesiologists. ⋯ Remifentanil can provide better postoperative pain control than apotel immediately after surgery.