Articles: acute-pain.
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Reg Anesth Pain Med · Apr 2024
Postsurgical opioid prescribing among veterans using community care for orthopedic surgery at non-VA hospitals compared to a VA hospital with a transitional pain service: a retrospective cohort study.
The USA provides medical services to its military veterans through Veterans Health Administration (VHA) medical centers. Passage of recent legislation has increased the number of veterans having VHA-paid orthopedic surgery at non-VHA facilities. ⋯ These results suggest that veterans who have surgery at a veterans affairs hospital with a transitional pain service are at lower risk for larger opioid prescriptions both at discharge and within 90 days after surgery as well as persistent opioid use beyond 90 days after discharge than if they have surgery at a community hospital.
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Anaesth Intensive Care · Apr 2024
Evaluation of opioid prescribing for surgical patients discharged from three metropolitan hospitals between 2012 and 2020.
This multicentre, retrospective medical record audit evaluated opioid analgesia prescribing within a Victorian metropolitan public hospital network. The study included all surgical patients discharged between January 2012 and December 2020 with one or more discharge prescriptions from three metropolitan hospitals (n = 117,989). The main outcome measures were mean oral morphine equivalent daily dose (OMEDD), mean number of opioid types and proportion of patients prescribed one or more slow-release opioids on discharge. ⋯ Subanalysis was undertaken to evaluate key changes in the opioid prescribing landscape in the health network. The removal of default opioid pack sizes in the electronic medication management system (December 2014) and the release of the Faculty of Pain Medicine-Australian and New Zealand College of Anaesthetists' statement regarding the use of opioid analgesics in patients with chronic non-cancer pain (March 2018) were associated with significant reductions in mean OMEDD prescribed on discharge (136 mg vs 122 mg and 120 mg vs 85.4 mg, respectively, P < 0.001). In conclusion, the quantity of opioids prescribed on discharge in this patient group peaked in 2013 and has been decreasing since.
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his study aimed to systematically evaluate the clinical efficacy of gabapentin and pregabalin in the treatment of acute herpes zoster neuralgia, including pain control and the occurrence of adverse effects. ⋯ CRD42023446643.
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Reg Anesth Pain Med · Apr 2024
Anesthesia start time documentation accuracy where peripheral nerve block is the primary anesthetic.
When used as the primary anesthetic, nerve blocks are not billed as separate procedures. In this scenario, the anesthesia start (AStart) time should include the block procedural time. We measured how often AStart time was documented before the nerve block was placed in the preoperative area, and compared cases where a block team performed the nerve block and cases where the intraoperative anesthesia attending supervised the nerve block. We hypothesized that the involvement of a regional anesthesia team would lead to more accurate documentation of AStart. We also estimated the lost revenue due to inaccurate start time documentation. ⋯ The performance of primary regional anesthesia procedure by a block team increased the incidence of inaccurate documentation and uncaptured potential revenue. There is need for education about accurate nerve block documentation for anesthesiologists, especially when separate teams are used.
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Acute physical activity leads to exercise-induced hypoalgesia (EIH). However, to what degree it can be induced by very short but highly intensive exercise is largely unknown. This study aims to investigate the effects of two different short all-out isokinetic exercise sessions on EIH. ⋯ This study investigates the potential for brief, highly intensive exercise sessions to induce exercise-induced hypoalgesia (EIH). The research demonstrates that EIH can indeed be triggered by such short workouts, with greater effects observed during a 90 s session compared to a 15 s one, most likely due to higher subjective and objective exertion. These findings offer insights into the potential for extremely brief but intense exercises to alleviate pain, impacting exercise recommendations and pain management strategies.