Risk Factors for Prolonged Postoperative Opioid Use After Spinal Fusion for Adolescent Idiopathic Scoliosis

Background: Opioids are commonly used after posterior spinal instrumented fusion (PSIF) for adolescent idiopathic scoliosis (AIS). Prescription opioids use can potentially lead to misuse, abuse, dependence, and overdose death. Prolonged opioid use has not been extensively studied in the postoperative AIS population. The purpose of this study is to identify risk factors associated with prolonged opioid use after PSIF for AIS. Methods: A large insurance database was queried for AIS patients undergoing PSIF. Patients with prolonged postoperative opioid use were defined as those receiving new prescriptions for an opioid medication>6 weeks following the date of surgery, up to 8 months postoperatively. Preoperative and intraoperative risk factors for prolonged opioid use were then examined, including the number of spinal levels fused, preoperative opioid prescriptions, demographic variables, pertinent comorbidities (anxiety, depression, attention deficit hyperactivity disorder, and autism) and other preoperative prescriptions (anxiolytics, antidepressants, nonopioid analgesics, neuropathic medications, and attention deficit hyperactivity disorder medications). Each variable’s independent risk for prolonged postoperative opioid use was examined utilizing a multivariable binomial regression analysis. P
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research

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The objective of this study was to assess the clinical and radiographic outcomes of surgical management in a multicentre cohort of paediatric patients with burst fractures, in order to devise an optimal therapeutic strategy.HypothesisA therapeutic strategy for burst fractures in children and adolescents can be devised based on data from a patient cohort and on previously published information.Material and methodsPatients younger than 18 years who were managed surgically for one or more burst fractures (Magerl A3) were included in this retrospective multicentre study. Clinical, radiographic, and surgical data were collected...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. Methods: Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. Results: Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (...
Source: Ghana Medical Journal - Category: African Health Tags: Ghana Med J Source Type: research
ConclusionsType of developmental disability, and characteristics of the non-disabled sibling and their family are associated with mental health outcomes of siblings of children with a DD.
Source: Research in Developmental Disabilities - Category: Disability Source Type: research
Conclusions and ImplicationsThese findings suggest that the narrative coherence of autistic children’s witness accounts is equivalent to TD peers of comparable age and ability.
Source: Research in Developmental Disabilities - Category: Disability Source Type: research
You're reading The Surprising Connection Between Anxiety and Confidence, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles. In today’s modern era, with always-on technology and ever-increasing job demands, many people are fighting a silent battle. The battle of feeling overwhelmed. Our clients tell us they’re feeling anxious, stuck, and adrift. They struggle to process information and feel paralyzed when faced with important decisions. Once competent and productive, they say they have effectively lost co...
Source: PickTheBrain | Motivation and Self Improvement - Category: Consumer Health News Authors: Tags: featured psychology self improvement agency Anthony Rao anxiety and confidence Paul Napper The Power of Agency Source Type: blogs
CONCLUSIONS: The present work augments prior evidence that psychological stressors possess important drivers of CVD onset and progression mainly in women while it gives rise to research towards unidentified paths behind this claim. PMID: 31740355 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Cardiology - Category: Cardiology Tags: Hellenic J Cardiol Source Type: research
Abstract BACKGROUND: Induction of anesthesia can be distressing both for children and their parents. Nonpharmacological behavioral interventions can reduce the anxiety of children without significant adverse effects as seen with sedative medications. We hypothesized that the use of incentive-based game therapy in conjunction with parental involvement would be a simple and cost-effective intervention in reducing the preoperative anxiety in children. METHODS: Eighty children between the age group of 4 and 8 years scheduled to undergo surgery were randomly assigned to a control group (n = 40) and intervention gr...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
CONCLUSIONS: Dex sedation during EPSs is not associated with a reduction in PSVT inducibility. The therapeutic utility of Dex during EPS arises from the predictable sedation Dex affords but is associated with an increased incidence of intraprocedure hypotension. PMID: 31743172 [PubMed - in process]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
CONCLUSIONS: The results suggest that the activation of microglia in the hippocampus plays an important role in the development of pain and depressive-like behaviors in bone cancer condition. PMID: 31743195 [PubMed - in process]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
In this study, 120 patients with non-specific low back pain were included. The Roland Morris Disability Questionnaire, Oswestry Disability Index, Beck Depression Inventory, Tampa Scale for Kinesiophobia, and the StarT Back Screening Tool were administered. One week after the initial testing, the same examiner repeated the tests. RESULTS: The mean age of the patients who participated in the study was 35.54±12.45 years. Cronbach's alpha coefficients in the analysis of scale reliability were 0.747 for the overall scale and 0.738 for the psychosocial subscale. The test-retest reliability of StarT Back Screening Tool...
Source: Agri Dergisi - Category: Anesthesiology Tags: Agri Source Type: research
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