Articles: opioid.
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Observational Study
Tapentadol: navigating the complexities of abuse, patient safety & regulatory measures.
To evaluate tapentadol abuse cases by analyzing real-world data and identifying under-reporting countries from Southeast Asian Region (SEAR) to enhance vigilance. ⋯ Stringent regulatory actions are needed to curb this practice in India, such as rescheduling tapentadol from Schedule H (Prescription drugs) to Schedule X(Narcotic drugs) in India could offer more regulatory oversight and measures to reduce risks related to abuse, addiction, and dependence while enhancing patient safety in pain management practices. Additionally, tapentadol should be closely monitored in other SEAR countries due to its potential for dependence. This study also emphasizes the importance of encouraging SEAR countries to report more Adverse Drug Reactions (ADRs), which would facilitate the implementation of more rigorous regulatory measures.
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There is much concern that substance use treatment programs are rarely integrated with smoking cessation programs. Here, the first national statistics are presented on the connection between heavy vs. light smoking and the opioid epidemic. ⋯ As nations deal with the opioid epidemic, integrating smoking cessation programs into substance abuse treatment programs appears prudent.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Predictors of Postoperative Morphine Milligram Equivalents in Cardiac Surgery.
Given both the short- and long-term deleterious effects of opioids, there has been an increased focused on reducing the use of postoperative opioid analgesia. As patients undergoing cardiac surgery often require high levels opioids postoperatively, understanding risk factors for increased postoperative opioid use may be helpful for the development of patient-specific opioid-sparing pain regimens for this patient population. ⋯ CABG, liver disease, patient-controlled analgesia, younger age, and higher BMI are associated with increased narcotic use after cardiac surgery. Implementation of more aggressive perioperative multimodal opioid-sparing regimens should be considered for these patient groups.
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Journal of anesthesia · Dec 2024
Decrease of the peak heights of EEG bicoherence indicated insufficiency of analgesia during surgery under general anesthesia.
Studies show that the two peak heights of electroencephalographic bicoherence (pBIC-high, pBIC-low) decrease after incision and are restored by fentanyl administration. We investigated whether pBICs are good indicators for adequacy of analgesia during surgery. ⋯ Superior to standard anesthesia monitoring, pBICs are better indicators of analgesia during surgery.