Articles: opioid.
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Rainer Sabatowski qualified as anesthesiologist in 1995 and as pain specialist in 2003. He was head of a pain clinic at the University of Cologne, Germany, from 2002 to 2007. Since 2007 he has been head of the Comprehensive Pain Center at the University Hospital "Carl Gustav Carus" at the Technical University Dresden (Germany). ⋯ He has spoken at many national and international pain meetings and was scientific chair of the 8th Palliative Care Congress of the German Society of Palliative Care in Dresden in 2010. He has published over 100 papers and book chapters and is on the editorial board of several pain journals. He is also a member of the advisory board of the German IASP chapter and works in several focus groups of this pain society.
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Opioids are potent broad-spectrum analgesics useful to treat a variety of painful conditions. Opioids have been classified by many different categorizations (e.g. natural, semisynthetic, synthetic). One classification that may be useful in terms of selecting specific opioid agents is based on the pharmacokinetic characteristics of the various opioid formulations (e.g. longacting opioids, short-acting opioids, and rapid onset opioids). ⋯ Rapid onset opioids appear especially well-suited to treat breakthrough pain and in particular, rapidonset breakthrough pain. This article will briefly review 5 rapid onset opioids that are FDA approved in the U. S.
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The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. ⋯ Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.