Articles: opioid.
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Randomized Controlled Trial
Complications with focus on delirium during hospital stay related to femoral nerve block compared to conventional pain management among patients with hip fracture - A randomised controlled trial.
Patients with hip fracture often suffer complications leading to increased mortality and morbidity. Pain management are important, but opioids has many side effects. The aim of this study was to investigate whether Femoral Nerve Block (FNB) can reduce complications during hospital stay, with special focus on delirium compared to conventional pain management with opioids among patients with hip fracture, including those with dementia. ⋯ Despite less preoperative pain and need of opioids, FNB did not reduce the incidence of complications. However, a preoperative FNB may result in less preoperative delirium, but this should be further investigated. As pain treatment, FNB is a good alternative with few documented adverse effects in order to reduce pain and opioids among patients with hip fracture.
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Randomized Controlled Trial
Preemptive analgesia with a single low dose of intrathecal morphine in multilevel posterior lumbar interbody fusion surgery: a double-blind, randomized, controlled trial.
Patients undergoing lumbar spinal surgery may experience considerable pain in the early postoperative period, and poor pain control after multilevel lumbar spinal fusion surgery is frequently associated with multiple complications and delayed discharge from hospital. ⋯ Preemptive analgesia with ITM results in significantly improved early postoperative pain control and decreased postoperative patient-controlled intravenous analgesia consumption, with no increase in adverse effects.
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Randomized Controlled Trial Pragmatic Clinical Trial
Sleep Disturbance Predicts Less Improvement in Pain Outcomes: Secondary Analysis of the SPACE Randomized Clinical Trial.
Sleep disturbance may limit improvement in pain outcomes if not directly addressed in treatment. Moreover, sleep problems may be exacerbated by opioid therapy. This study examined the effects of baseline sleep disturbance on improvement in pain outcomes using data from the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial, a pragmatic 12-month randomized trial of opioid vs nonopioid medication therapy. ⋯ Baseline sleep disturbance adversely affects pain response to treatment regardless of analgesic regimen. Recognition and treatment of sleep impairments that frequently co-occur with pain may optimize outcomes.
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Randomized Controlled Trial Multicenter Study
The effects of repetitive transcranial magnetic stimulation on cue-induced craving in male patients with heroin use disorder.
Craving is a central feature of addiction. Early evidence suggests that repetitive transcranial magnetic stimulation is effective in reducing cue induced craving for patients with opioid use disorder (OUD). However, trials in large populations of patients with OUDs are lacking. ⋯ Our results suggest that rTMS applied to the DLPFC is effective in reducing craving severity in heroin use disorder patients. Our results also suggest that such treatment effects can last for up to 60 days after treatment cessation.
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Randomized Controlled Trial Clinical Trial
Postoperative analgesia and opioid use following hip arthroscopy with ultrasound-guided quadratus lumborum block: a randomized controlled double-blind trial.
To investigate the postoperative analgesic effect of ultrasound-guided quadratus lumborum block (QLB) in patients undergoing arthroscopic hip surgery. ⋯ Hip arthroscopy patients who received QLB and general anesthesia in combination had less pain and a lower opioid requirement within 24 hours postoperatively.