Stemming the Tide of Opioid Addiction-Dramatic Reductions in Postoperative Opioid Requirements Through Preoperative Education and a Standardized Analgesic Regimen.

Stemming the Tide of Opioid Addiction-Dramatic Reductions in Postoperative Opioid Requirements Through Preoperative Education and a Standardized Analgesic Regimen. Mil Med. 2019 Oct 17;: Authors: Sheldon RR, Weiss JB, Do WS, Forte DM, Carter PL, Eckert MJ, Sohn VY Abstract INTRODUCTION: Surgery is a known gateway to opioid use that may result in long-term morbidity. Given the paucity of evidence regarding the appropriate amount of postoperative opioid analgesia and variable prescribing education, we investigated prescribing habits before and after institution of a multimodal postoperative pain management protocol. MATERIALS AND METHODS: Laparoscopic appendectomies, laparoscopic cholecystectomies, inguinal hernia repairs, and umbilical hernia repairs performed at a tertiary military medical center from 01 October 2016 until 30 September 2017 were examined. Prescriptions provided at discharge, oral morphine equivalents (OME), repeat prescriptions, and demographic data were obtained. A pain management regimen emphasizing nonopioid analgesics was then formulated and implemented with patient education about expected postoperative outcomes. After implementation, procedures performed from 01 November 2017 until 28 February 2018 were then examined and analyzed. Additionally, a patient satisfaction survey was provided focusing on efficacy of postoperative pain control. RESULTS: Preprotocol, 559 patients met inclusion criteria. About 97.5% were provided an ...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Related Links:

So in this "fellowship" that i resigned from recently, I asked long time ago whether tail was covered.I was told yes. When I signed paperwork after resigining I was told that I'd be covered for the premium for the tail. When I was like what?! That's not what I was told. I was told that "it would be covered if I finished the fellowship." That seems shady and illegal. Obviously paying thousands of dollars for tail would be reasonable on an attending salary, but now it seems they are pissed I... Tail coverage
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
The objectives of our study were to (i) examine the rate of vesico-ureteral injury at benign hysterectomy by surgical approach and (ii) compare the risk of vesico-ureteral injury specifically between minimally-invasive laparoscopic and abdominal hysterectomy on a populational level.DesignRetrospective population-based observational study.SettingThe National Inpatient Sample.Patients501,110 women who underwent hysterectomy for benign gynecological disease from 1/2012-9/2015 were included: total abdominal hysterectomy (TAH, n=284,365 [56.7%]), total laparoscopic hysterectomy (TLH, n=60,410, [12.1%]), abdominal supracerv...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 17 November 2019Source: Pharmacological ResearchAuthor(s): Victor Fattori, Tiago H. Zaninelli, Fernanda S. Rasquel-Oliveira, Rubia Casagrande, Waldiceu A. VerriAbstractWe now appreciate that the mechanism of resolution depends on an active and time-dependent biosynthetic shift from pro-inflammatory to pro-resolution mediators, the so-called specialized pro-resolving lipid mediators (SPMs). These SPMs are biosynthesized from the omega-3 fatty acids arachidonic acid (AA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), or docosahexaenoic acid (DHA). Despite effective for a fractio...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
This study aimed to investigate the mechanism of action of ginger extract and its compound, 6-shogaol, on pancreatic islets as well as on expressions of TRPV-1 and NMDAR2B in the spinal cord of streptozotocin (STZ)-induced mice model of PDN.Materials and methodsSixty-four 5–6 months old male-Balb/C mice were induced with 110 mg/kgBW STZ i.p., while eight mice were used as control group. Mice with blood glucose level ≥200 mg/d, that suffered hyperalgesia and allodynia were classified as PDN mice. Hot plate and von Frey filament tests were performed once a week until termination. At day 28 after considered as PDN,...
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionThe authors recommended short implants whenever the height of available bone permits optimum implant placement. The authors concluded that both treatment options are considered viable clinically and radiographically. However, short implants have shown reduced postoperative discomfort, minimal invasiveness, and reduced cost.
Source: Journal of Evidence Based Dental Practice - Category: Dentistry Source Type: research
ConclusionLimited available evidence suggests that patients with RAS may experience a reduction in the number of ulcers, DOU, NOE, and UP when using a SLS-free dentifrice as compared to using a dentifrice containing SLS.
Source: Journal of Evidence Based Dental Practice - Category: Dentistry Source Type: research
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential. When does an opioid prescription make sense? It is simply impossib...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Source Type: blogs
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumat...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone). 1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs
More News: Acetaminophen | Addiction | Appendectomy | Cholecystectomy | Education | Hernia Repair | International Medicine & Public Health | Laparoscopy | Lortab | Morphine | Pain | Pain Management | Statistics | Universities & Medical Training