Articles: opioid.
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Acta Anaesthesiol Scand · Jan 2025
Procedure time-of-day effects on postoperative opioid requirements in children.
Postoperative analgesic requirements in adults follow circadian rhythm patterns with requirements for opioids and local anesthetics highest in the morning. Procedure time of day may also potentially affect circadian rhythm patterns with surgery at night promoting wakefulness during nighttime hours. This disruption may produce a shift in the circadian rhythm and potentially affect when postoperative opioid requirements are highest. We hypothesized that children undergoing surgery at night would have higher postoperative opioid requirements during nighttime hours secondary to a shift in the circadian rhythm with those requirements remaining higher than daytime requirements for the duration of the hospital stay. ⋯ We found that procedure time of day did not impact postoperative opioid requirements in children undergoing a laparoscopic appendectomy for complicated appendicitis. Both children undergoing an appendectomy during the day or at night required more morphine equivalents during daytime hours than during nighttime hours. Surgery at night did not produce a shift in opioid requirements postoperatively from daytime hours to nighttime hours in children undergoing an appendectomy at night.
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The erector spinae plane block (ESPB) is a relatively new regional anesthetic procedure that provides analgesia below the erector spinae muscles in an interfascial plane. The indications for its use continue to expand as we learn more about this block. ⋯ The erector spinae block is a safe and cost-effective intervention in refractory postherpetic neuralgia.
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More Americans died in 2021 from drug overdose than from vehicle accidents and firearms combined. Unlike earlier phases, the current epidemic is marked by its disproportionate impact on communities of color. This report investigates regional and substance-specific variations in racial disparities to generate possible insights into the various forces shaping these trends. ⋯ The opioid epidemic continues to expand, with particularly rapid acceleration in racially minoritized communities. The growing role of stimulants in opioid overdose deaths is a racialized phenomenon disproportionately impacting Black and Native Americans. Wide variation in state-level disparities suggest that structural racism impacts health in regionally specific ways, highlighting the need for regional solutions.
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Anesthesia and analgesia · Dec 2024
Associations Between Social Determinants of Health and Opioid-Use Disorder Among Chronic Pain Patients From a Multi-Institutional Dataset.
This study examined the association between opioid-use disorder (OUD)-related diagnoses (eg, opioid dependence) and social determinants of health (SDoH) among patients with chronic pain. ⋯ The study revealed a significantly greater social disadvantage metric in chronic pain individuals with OUD.