Articles: opioid.
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Opioid specialty clinics have emerged as an approach for mitigating the risks associated with opioid therapies. Many opioid specialty clinics within the Department of Veterans Affairs (VA) have been described in the extant literature, yet veterans' experiences of these remain absent. This research study was undertaken to describe veterans' responses (e.g., knowledge, attitudes, and beliefs) toward being evaluated in an opioid specialty clinic. ⋯ For veterans prescribed opioid therapies, this clinic served as an adjunct service for ensuring appropriate and safe prescribing. Data from this study can be used to inform interventions to promote veterans' understanding across the total opioid safety clinic experience-referral, actual visit, and follow-up.
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Observational Study
Cutoff Values for Providing the Ideal Intravenous Patient-Controlled Analgesia According to the Intensity of Postoperative Pain-A Retrospective Observational Study.
Background and Objectives: The cutoff values were analyzed for providing the ideal intravenous patient-controlled analgesia (PCA) that could reduce rescue analgesics or antiemetics requirements, based on the grades of postoperative pain intensity (PPI). Materials and Methods: PCA regimens of 4106 patients were retrospectively analyzed, and they were allocated into three groups with low, moderate, and high PPI grades (groups L, M, and H, respectively) based on numeric rating scores obtained 6 h postoperatively. Opioid and non-opioid analgesic doses were converted into fentanyl-equivalent doses (DOSE-FEN-OP and DOSE-FEN-NONOP, respectively). ⋯ In assessments of the analgesic doses to reduce rescue antiemetic requirement, DOSE-FEN-OP was ≤950 μg for groups L and M and ≤850 μg for Group H, while DOSE-FEN-NONOP was ≤50 μg, ≤450 μg, and ≤700 μg for groups L, M, and H, respectively. Conclusion: The ideal PCA for reduction in rescue analgesics or antiemetics can be achieved by adjustment of PCA settings and drug dosages carefully with these cutoff values depending on the expected grades of PPI. Especially, the ideal PCA can be provided by adjusting the lockout interval and bolus volume rather than BIR and by applying smaller bolus doses and shorter lockout intervals with an increasing PPI grade.