The Utilization of Buprenorphine in Chronic Pain
Publication date: Available online 3 July 2020Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Cynthia Pham, Daniel Swanson, Kevin Berardino, Prudhvi Bandi, Ariunzaya Amgalan, Rachel J. Kaye, Jai Won Jung, Alan D. Kaye, Antonella Paladini, Giustino Varrassi, Adam M. Kaye, Laxmaiah Manchikanti, Omar Viswanath
AbstractBackgroundA currently unsolved problem of open inguinal hernia repair (IHR) is chronic postoperative inguinal pain (CPIP), which affects 10 –12% of patients after IHR. In the present paper, we explored the results of a newly designed partially absorbable mesh made of polypropylene and polylactic acid (HybridMesh®) for open hernia repair and its impact on postoperative safety, efficacy, comfort and pain.MethodsA prospective multicentric pilot trial was conducted in third-referral centers across Italy (n = 5). Inclusion criteria were unilateral primary inguinal hernia in patients of both genders and BMI
Abstract The adaptive significance of acute pain (to withdraw from tissue-damaging or potentially tissue-damaging external stimuli, and to enhance the salience of the stimulus resulting in escape and avoidance learning) and tonic pain (to enforce recuperation by punishing movement) are well-accepted . Pain researchers, however, generally assert that chronic pain has no adaptive significance, representing instead a pathophysiological state. This belief was recently challenged by the observation  that nociceptive sensitization caused by a chronic pain-producing injury reduced predation risk in squid (Doryteuth...
40 yo F morbid obesity (BMI 50 w/ OSA requiring CPAP) presents for bariatric surgery - laparoscopic. H/o Chiari malformation, h/o hydrocephalus w/ ventricular-thoracic shunt and lumbar-peritoneal-shunt s/p multiple revisions for failure and optic nerve fenestration for blindness, chronic neck/headaches on Norco 10-325, gabapentin 300 once daily, flexeril, fibromyalgia. Thoughts on pre-intra-post operative pain control options? Neuraxial? Multimodal? How would you manage her preop opioid use?
THE HEALTH CRISIS caused by opioid abuse has prompted a reappraisal of these agents in contemporary perioperative cardiothoracic practice due to the significant social and economic impact that has resulted.1 Furthermore, perioperative pain management is a key factor in enhanced recovery after cardiac surgery to minimize mortality and morbidity, including the risks of downstream chronic pain.2-3 The growing imperative is therefore to provide high-quality perioperative analgesia for cardiothoracic patients with opioid-sparing or even opioid-free techniques.
Publication date: Available online 17 July 2020Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Filomena Puntillo, Mariateresa Giglio, Nicola Brienza, Omar Viswanath, Ivan Urits, Alan D. Kaye, Joseph Pergolizzi, Antonella Paladini, Giustino Varrassi
Am J Perinatol DOI: 10.1055/s-0040-1714392 Objective The study aimed to test the hypothesis that higher Edinburgh Postnatal Depression Scale (EPDS) scores are associated with increased pain scores and opioid use during postpartum hospitalization following cesarean section. Study Design We conducted a retrospective cohort of English or Spanish-speaking women ≥18 years who had prenatal care for a singleton gestation and delivered by cesarean at ≥36 weeks within a tertiary center during 2017. Exclusions included women with fetal anomalies, intrauterine fetal demise, sickle cell disease, previously diagno...
Abstract Pain following mastectomy and breast reduction surgery is significant and leads to longer hospital length of stay and higher hospital costs, as well as chronic pain syndromes. While the majority of research has focused on female patients undergoing mastectomy or breast reduction for neoplasm or non-transgender surgery, a growing population of patients includes the transgender patient population, from whom there is minimal data regarding pain control. Females seem to be at higher risk for developing severe pain in the post-operative period and report higher post- operative pain scores in the literature. ...
This article addresses the long-term consequences for survivors of COVID-19 who developed acute respiratory distress syndrome, which may include PTSD, chronic pain, and a fibromyalgia-like syndrome.Anesthesia &Analgesia
Nearly 50,000 US adults experience opioid-overdose deaths annually and 1.7 million experience a substance use disorder from prescription opioids. Hence, understanding analgesia strategies is of utmost importance. A pre-operative analgesic plan can consist of a brief conversation between the surgeon, patient, and anesthesiologist in an uncomplicated case or range all the way to an involved, multidisciplinary plan for a chronic pain patient. Over the past several decades, there have been myriad studies examining perioperative analgesic regimens for otolaryngologic procedures, many of which have demonstrated the efficacy of nonopioid analgesics.
THE DEVELOPMENT of enhanced recovery after surgery has encouraged the evolution of opioid-sparing techniques and opioid-free anesthesia (OFA).1,2 In addition, the use of intraoperative opioids can be associated with postoperative hyperalgesia and tolerance, leading to higher pain scores and increased opioid consumption.3,4 Furthermore, the opioid epidemic and chronic long-term opioid usage have been attributed, in part, to the use of opioids in the perioperative period.5,6 The administration of intraoperative opioids in oncologic surgery also has been implicated as a potential causative agent for cancer recurrence.