Articles: opioid.
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J. Korean Med. Sci. · Oct 2024
Association of Preoperative Opioid and Glucocorticoid Use With Mortality and Complication After Total Knee or Hip Arthroplasty.
The association between preoperative opioid or glucocorticoid (GC) use and clinical outcomes, such as postoperative mortality after total joint arthroplasty (TJA), is unclear. ⋯ Preoperative GC use and concomitant use of opioid analgesics with GC were associated with increased postoperative mortality and morbidity after TJA. However, preoperative chronic opioid analgesic use alone did not affect postoperative mortality or morbidity.
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Opioids are known to cause respiratory depression, aspiration, and to suppress the immune system. This study aimed to investigate the relationship between short- and long-term opioid use and the occurrence and clinical outcomes of pneumonia in South Korea. ⋯ Both short- and long-term opioid prescriptions were associated with higher incidences of pneumonia and hospital-treated pneumonia. In addition, long-term opioid prescriptions were linked to higher mortality rates due to pneumonia.
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Anesthesia and analgesia · Oct 2024
Variations in Current Practice and Protocols of Intraoperative Multimodal Analgesia: A Cross-Sectional Study Within a Six-Hospital US Health Care System.
Multimodal analgesia (MMA) aims to reduce surgery-related opioid needs by adding nonopioid pain medications in postoperative pain management. In light of the opioid epidemic, MMA use has increased rapidly over the past decade. We hypothesize that the rapid adoption of MMA has resulted in variation in practice. This cross-sectional study aimed to determine how MMA practices have changed over the past 6 years and whether there is variation in use by patient, provider, and facility characteristics. ⋯ In a large integrated US health care system, approximately 50% of noncardiac surgery patients received MMA. Still, there was wide variation in MMA use by patient and procedure characteristics and across hospitals and anesthesiologists. Our findings highlight a need for further research to understand the reasons for these variations and guide the safe and effective adoption of MMA into routine practice.
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Treatment of postoperative pain for children with severe neurologic impairment (SNI) is challenging. We describe the type, number of classes, and duration of postoperative pain medications for procedures common among children with SNI, as well as the variability across children's hospitals in pain management with an emphasis on opioid prescribing. ⋯ There is substantial variability in the postoperative delivery of pain medications for children with SNI. A standardized approach may decrease the variability in postoperative pain control and enhance care for children with SNI.