Articles: opioid.
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Comparative Study Observational Study
Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge: A nationwide cohort study.
Although analgesics are initiated on hospital discharge in millions of adults each year, studies quantifying the risks of opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) among older adults during this transition are limited. We sought to determine the incidence and risk of post-discharge adverse events among older adults with an opioid claim in the week after hospital discharge, compared to those with NSAID claims only. ⋯ Older adults filling an opioid prescription in the week after hospital discharge were at higher risk for mortality and other post-discharge adverse outcomes compared to those filling an NSAID prescription only.
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J Pain Palliat Care Pharmacother · Sep 2021
Subcutaneous Patient-Controlled Analgesia in Palliative Care.
Subcutaneous patient-controlled analgesia (SCPCA) is an underutilized method of pain management in palliative care patients. In a select group of patients, including patients in whom enteral analgesia is ineffective or undeliverable, and in patients with limited access to healthcare due to geographical or other logistic issues, SCPCA can provide an effective and safe alternative.
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Palliative medicine · Sep 2021
Professionals', patients' and families' views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process.
In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. ⋯ There are significant barriers and enablers to the use of opioids for the symptomatic reduction of chronic breathlessness based on the knowledge, views and attitudes of clinicians, patients and families. Clinicians' interactions with patients and their families strongly influences adherence with opioid treatment regimens for chronic breathlessness. Clinicians', patients' and families' knowledge about the delicate balance between benefits and risks is generally poor. Education for all, but particularly clinicians, is likely to be a necessary (but insufficient) factor for improving implementation in practice.
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Persistent Opioid Use after Ophthalmic Surgery in Opioid-Naive Patients and Associated Risk Factors.
To determine the rate and risk factors for new persistent opioid use after ophthalmic surgery in the United States. ⋯ Exposure to opioids in the perioperative period is associated with new persistent use in patients who were previously opioid-naive. This suggests that exposure to opioids is an independent risk factor for persistent use in patients undergoing incisional ophthalmic surgery. Surgeons should be aware of those risks to identify at-risk patients given the current national opioid crisis and to minimize prescribing opioids when possible.
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Paediatric anaesthesia · Sep 2021
An assessment of opioids on respiratory depression in children with and without obstructive sleep apnea.
Obstructive sleep apnea is a risk factor for respiratory depression following opioid administration as well as opioid-induced hyperalgesia. Little is known on how obstructive sleep apnea status is associated with central ventilatory depression in pediatric surgical patients given a single dose of fentanyl. ⋯ In pediatric surgical patients, obstructive sleep apnea status was not associated with significant differences in central respiratory depression following a single dose of fentanyl (1 mcg/kg). These findings can help determine safe opioid doses in future pediatric obstructive sleep apneapatients.