Chronic Opioid Use Is Associated With Surgical Site Infection After Lumbar Fusion

Study Design. Retrospective, database review. Objective. The purpose of this study was to explore the association between preoperative opioid use and postoperative infection requiring operative wound washout in elective lumbar fusion patients. Summary of Background Data. Numerous peer-reviewed publications have conducted multivariate analyses of risk factors for surgical site infection. However, few have explored preoperative opioid use. Opioids have been widely prescribed preoperatively for pain management, but their effect on postsurgical infection is currently inconclusive. Methods. We retrospectively queried the PearlDiver national insurance claims database and included patients from 2007 to 2017 with a history of lumbar fusion. Any interbody fusion history designated exclusion. We stratified patients by single or multilevel procedures and conducted univariate analyses of previously documented infection risk factors, as well as our variable of interest, chronic preoperative opioid use. Variables associated (P 
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research

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CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. PMID: 32623724 ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
We report four cases of effective analgesia for intractable secondary headache resistant to medical management with high thoracic ESP blocks. In each case, the ESP block provided instant pain relief. We suggest that the findings of this case series indicate that the ESP block may be a useful intervention in patients with severe secondary headache or posterior cervical pain where conventional therapies have limited success, though more studies are necessary. PMID: 32606918 [PubMed]
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
AbstractVoltage ‐gated potassium channels (Kv) are important regulators of neuronal excitability for its role of regulating resting membrane potential and repolarization. Recent studies show that Kv channels participate in neuropathic pain, but the detailed underlying mechanisms are far from being clear. In the c urrent study, we used siRNA, miR‐137 agomir and antagomir to regulate the expression of Kv1.2 in spinal cord and dorsal root ganglia (DRG) of naïve and chronic constriction injury (CCI) rats. Kv currents and neuron excitability in DRG neurons were examined by patch‐clamp whole‐cell recording to verify...
Source: Journal of Neurochemistry - Category: Neuroscience Authors: Tags: ORIGINAL ARTICLE Source Type: research
At certain times, it might seem impossible to find a few moments of peace in your life. If you have a lot of responsibilities or worries, you may feel caught in a whirlwind of trying to get things done while trying to deal with problems or your own complex emotions. Other people impact your sense of peace, too, when they ask you to do more than you feel you can handle comfortably or when they cause additional issues. The good news is, no matter how difficult your external life is, you can add healing peace to each day. This won’t magically make everything okay, but it can help you deal with stress and protect your h...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Anxiety and Panic General Self-Help Stress Calm Organization overwhelm Self Care stress reduction Time Management Source Type: blogs
Conditions:   Low Back Pain;   Pain Measurement;   Chronic Pain;   Analgesia, Epidural;   Clinic, Pain Interventions:   Procedure: Fluoroscopically guided lumbar medial branch nerve radiofrequency denervation.;   Procedure: Fluoroscopically guided lumbar facet joint injection.;   Procedure: Fluoroscopically guided lumbar epidural corticosteroid injection.;   Procedure: Fluoroscopically guided caudal epidural c orticosteroid injection.;   Procedure: Fluoroscopically guided pulsed radiofrequency of the lumbar dorsal root ganglion.;   Procedu...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). SETTING: Governmental and private institutions. PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. INTERVENTIONS: The EG received full version of the applic...
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
Good news: neuroscientists tell us that humans are hard-wired for optimism. Makes sense when you think about it — our ancestors went hunting and gathering and sailing and sewing and so on because they expected something good.  Optimism itself is good — good for our health. According to a recent New York Times article, more and more long-term studies show that optimism fosters “exceptional” longevity and lowers the risk of cardiovascular disease and other chronic ailments. Other studies have concluded optimists have better pain management, immune response and physical function. But with all that...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Motivation and Inspiration Self-Help Optimism Source Type: blogs
Mainstay Medical, an Irish firm, just won FDA approval to introduce its ReActiv8 neurostimulator that works to address the underlying causes of back pain. Most existing pain reducing implants work to simply mask the pain by delivering electrical sign...
Source: Medgadget - Category: Medical Devices Authors: Tags: Neurology Neurosurgery Orthopedic Surgery Pain Management Source Type: blogs
Authors: Talbot LA, Wilson C, Nayback-Beebe A, Metter EJ, Hatzfeld J Abstract This is a review of the proceedings of the first Military Nursing Back Pain Summit focusing on nursing's role in preventing and managing back pain. The purpose of the summit was to present the state of the science in back pain and to identify key gaps in research, policy, education, and treatment that could be undertaken by military nurses, nurse leaders, nurse practitioners, and nurse scientists. Several key points were highlighted during the summit: (1) back pain is multifactorial and preventable; (2) military service members have uniqu...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
In conclusion, carbophenyline showed anti-neuropathic properties both after acute and chronic treatment with preventive effect agains t oxaliplatin-induced astrocyte activation in the spinal cord. Therefore, I1-R agonists emerge as a new class of candidates for the management of oxaliplatin-induced neuropathic pain.
Source: Neurotherapeutics - Category: Neurology Source Type: research
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