Articles: opioid.
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Meta Analysis Comparative Study
Comparative Effectiveness of Analgesics to Reduce Acute Pain in the Prehospital Setting.
Objectives: The objectives of this study were to assess comparative effectiveness and harms of opioid and nonopioid analgesics for the treatment of moderate to severe acute pain in the prehospital setting. Methods: We searched MEDLINE®, Embase®, and Cochrane Central from the earliest date through May 9, 2019. Two investigators screened abstracts, reviewed full-text files, abstracted data, and assessed study level risk of bias. ⋯ Combining an opioid and ketamine may reduce acute pain more than an opioid alone but comparative harms are uncertain. When initial morphine is inadequate, giving ketamine may provide greater and quicker acute pain relief than giving additional morphine, although comparative harms are uncertain. Due to indirectness, strength of evidence is generally low, and future research in the prehospital setting is needed.
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Review Meta Analysis
Utilizing the commodity purchase task to evaluate behavioral economic demand for illicit substances: a review and meta-analysis.
The commodity purchase task is a simulated demand procedure that is easy and quick to complete (< 5 minutes) as well as adaptable for remote delivery and use with varied study populations. The purpose of this meta-analysis was to synthesize research using the commodity purchase task with illicit substances to evaluate the magnitude of omnibus effects sizes and moderators of the correlation of demand indices with quantity-frequency (QF) and severity measures. ⋯ Behavioral economic demand as measured by the commodity purchase task is consistently correlated with measures of illicit substance use quantity-frequency and severity.
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Cochrane Db Syst Rev · Feb 2020
Review Meta AnalysisDihydrocodeine for detoxification and maintenance treatment in individuals with opiate use disorders.
Medical treatment and detoxification from opiate disorders includes oral administration of opioid agonists. Dihydrocodeine (DHC) substitution treatment is typically low threshold and therefore has the capacity to reach wider groups of opiate users. Decisions to prescribe DHC to patients with less severe opiate disorders centre on its perceived safety, reduced toxicity, shorter half-life and more rapid onset of action, and potential retention of patients. This review set out to investigate the effects of DHC in comparison to other pharmaceutical opioids and placebos in the detoxification and substitution of individuals with opiate use disorders. ⋯ We found low-quality evidence that DHC may be no more effective than other commonly used pharmacological interventions in reducing illicit opiate use. It is therefore premature to make any conclusive statements about the effectiveness of DHC, and it is suggested that further high-quality studies are conducted, especially in low- to middle-income countries.
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To investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt. ⋯ This review demonstrated an inverse association between chiropractic use and opioid receipt among patients with spinal pain. Further research is warranted to assess this association and the implications it may have for case management strategies to decrease opioid use.
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Acta Anaesthesiol Scand · Jan 2020
Review Meta Analysis Comparative StudyLow- versus high-dose intraoperative opioids: a systematic review with meta-analyses and trial sequential analyses.
Opioid-induced hyperalgesia is a state of nociceptive sensitisation secondary to opioid administration. The objective of this meta-analysis was to test the hypothesis that high-dose intraoperative opioids contribute to increased post-operative pain and hyperalgesia when compared with a low-dose regimen in patients under general anaesthesia. ⋯ There is low certainty of evidence that high-dose intraoperative opioid administration increases pain scores in the post-operative period, when compared with a low-dose regimen.