Articles: opioid.
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Chronic low back pain (CLBP) incurs huge costs owing to increased healthcare expenditure, disability, insurance, and work absenteeism. Opioid analgesics are commonly used for the management of CLBP. ⋯ Oxymorphone has an advantage over other opioids to reduce pain by 30% and 50% in patients with CLBP.
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To assess the relative safety of oral tapentadol PR and other opioid analgesics for moderate or severe chronic pain in adults, we conducted a systematic review and network meta-analysis (NMA). ⋯ RCT evidence suggests that tapentadol can be a useful treatment option for patients suffering from chronic pain and in need of an opioid analgesic. Opioids should be prescribed by a qualified physician only after other analgesics have been considered, taking side effects and misuse risk into account.
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Meta Analysis
Gender Differences in Preoperative Opioid Use in Spine Surgery Patients: A Systematic Review and Meta-analysis.
Opioids are frequently used in spine surgeries despite their adverse effects, including physical dependence and addiction. Gender difference is an important consideration for personalized treatment. There is no review assessing the prevalence of opioid use between men and women before spine surgeries. ⋯ The prevalence of opioid use before spine surgery was similar between men and women, irrespective of surgery location or study duration. More studies characterizing the pattern of opioid use between genders are still needed.
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Meta Analysis
All-Cause and Overdose Mortality Risk Among People Prescribed Opioids: A Systematic Review and Meta-analysis.
To estimate all-cause and overdose crude mortality rates and standardized mortality ratios among people prescribed opioids for chronic noncancer pain and risk of overdose death in this population relative to people with similar clinical profiles but not prescribed opioids. ⋯ Methodological limitations in the identified literature complicate efforts to determine the overdose mortality risk of people prescribed opioids. There is a need for large-scale clinical trials to assess adverse outcomes in opioid prescribing, especially for chronic noncancer pain.
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Meta Analysis
Acupuncture for opioid-induced constipation: Protocol for a systematic review and meta-analysis.
Opioid-induced constipation (OIC) is one of the most common complications of analgesic therapy for cancer pain patients who suffer moderate to severe pain. Acupuncture as an effective treatment in constipation has been widely applied. But its efficacy has not been assessed systematically. Thus, the purpose of this study is to provide a protocol to explore the efficacy and safety of acupuncture for OIC. ⋯ The conclusion of our systematic review and meta-analysis may provide evidence of whether acupuncture treatment is beneficial to patients with OIC.INPLASY registration number: INPLASY2020100026.