Articles: opioid.
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Background: Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries. Objective: To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs. ⋯ Top barriers include religion factors, lack of appropriate education and training at all levels, nonadherence to guidelines, patients' reluctance to report on pains, over regulation associated with prescribing and access to opioid analgesics, fear of addiction to opioids, and lack of discussions around prognosis and treatment planning. Conclusion: The majority of patients with cancer in low-income countries are undertreated for their pain. Promoting cancer pain accredited program of training and education on pain management for physicians and nurses is crucial, as well as advocating policymakers and the public at large.
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Aim To investigate analgesic and side effects of different doses of fentanyl in combination with propofol for colonoscopy. Methods This prospective randomized double-blind study conducted between 2019 and 2020 included 64 patients. Patients were randomized: Group 1 (fentanyl 0.5 μg/kg) and Group 2 (fentanyl 1.0 μg/kg) both in combination with propofol. ⋯ Anxiety (p=0.010), weakness (p=0.000) and confusion (p=0.023) proved to be significantly higher for Group 1, and hypotension (p=0.001) for Group 2 than in another group. No statistical significance of Visual Analogue Pain Scale (VAS) (p=0.501) and Aldrete recovery score (ARS) (p=0.845) was found. Conclusion There was no significance in postprocedural abdominal pain between the group of patients administered fentanyl at a dose of 0.5 μg/kg and the group of patients administered fentanyl at a dose of 1.0 μg/kg; however, prevalence of complications was more significant in the group with a fentanyl at a dose of 0.5 μg/kg.
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Patients with injury may be at high risk of long-term opioid use due to the specific features of injury (e.g., injury severity), as well as patient, treatment, and provider characteristics that may influence their injury-related pain management. ⋯ Across this large cohort of multiple, mostly minor, injury types, long-term opioid use was relatively uncommon, but almost all patients with chronic use post injury had preinjury opioid use. Long-term opioid use after injury may be more closely tied to preinjury chronic pain and pain management than acute care pain management.
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Arch Orthop Trauma Surg · Aug 2022
Regional anesthesia does not decrease inpatient or outpatient opioid demand in distal femur fracture surgery.
Regional anesthesia (RA) is sometimes used to decrease pain and opioid consumption in distal femur fractures. However, the real-world impact of RA on inpatient opioid consumption and outpatient opioid demand is not well known. The hypothesis of this study is that RA would be associated with decreased inpatient opioid consumption and outpatient opioid demand. ⋯ Level III, retrospective, therapeutic cohort study.