64. Intravenous vs oral acetaminophen administration in perioperative care of one- and two-level LLIFs with instrumented posterior lumbar fusion: a comparative effectiveness study

Since 2000, the annual death toll from opioid associated overdose has increased by over 300%. To reduce the opioid consumption, physicians have used alternative approaches, which have proven to not only be effective, but also reduce the side effects such as nausea, constipation, and addiction. IV acetaminophen has been shown to successfully accomplish the reduction in opioid use, however, it is an expensive alternative. Testing the efficacy of IV acetaminophen vs its oral formulation will likely modify future postoperative pain management regimens while also addressing cost-effectiveness.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research

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As physicians, many of our daily practices involve administration of substances that are shrouded in mystery. Certain medications, specifically opioids, have been part of tragic news stories, and have turned young children into orphans, happy spouses into widows and widowers, and once-aspirational youth into memories. The CDC reports that on average, 130 people die each day from an opioid overdose. With such harrowing statistics, why take opioids in the first place? Well, if used appropriately, opioids can significantly improve pain with relatively tolerable side effects. A short-term course of opioids (typically 3 to 7 da...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Source Type: blogs
By Drs. David Niesel and Norbert Herzog The epidemic of opioid abuse and the resulting increases in overdoses and deaths have been front and center in the news for quite some time. Now a little appreciated effect called hyperalgesia, an increased sensitivity to pain, can make these drugs less effective for chronic pain leading people to take higher and higher doses seeking relief, increasing the chance of addiction. Opioids can actually prolong and amplify pain rather than relieving it. Opioids are pain relieving drugs that include hydrocodone, oxycodone, morphine, codeine and other related drugs including illegal ones s...
Source: Science - The Huffington Post - Category: Science Source Type: news
Conclusion This systematic review found no evidence that opioids provide a meaningful effect on chronic non-specific lower back pain. Opioids are often used as a last resort for people who have not responded to other painkillers. But these results found opioids gave only half the size of the effect that would be needed to make a real difference – about a 10-point score difference, rather than 20. On the whole, the body of evidence was high quality. A large number of trials where identified, and most were multi-centre trials with good sample sizes carried out in the US, Canada, Australia and Europe. This means ...
Source: NHS News Feed - Category: Consumer Health News Tags: Medication Medical practice Neurology Source Type: news
As America and the world mourns the death of music icon Prince, there has been speculation that his death was the result an opioid overdose. Yet, the music icon was known for his healthy lifestyle and his rejection of the drug culture that has become a cliché when talking about rock stars. The death of Prince underscores the opioid abuse epidemic in America that is created by the over-prescribing of opioids to treat pain known by names like Percocet, OxyContin, Fentanyl and Vicodin. Last year, American doctors prescribed enough opioids to give every American adult a one-month supply. 30 tablets that could lead to a...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Welp, we've done it, folks. It's finally come to this. There have been so many deaths from opioid overdose, so many addicts created, so many pills diverted, that the CDC is getting involved. Opioid pain medications, commonly prescribed to treat acute and chronic sources of pain, are a significant cause of morbidity (harm) and mortality (death) in America. In 2014, the CDC reported a total of 47,055 drug overdose deaths in the United States, 61% of which were attributable to opioids. So how exactly did we get here? Like most things in medicine, there is not one simple answer. But it's not that hard to trace things back a f...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Osteoarthritis (OA) affects tens of millions of Americans and is a leading cause of disability and reduced quality of life across the globe. Other than joint replacement surgery, there is no known “cure” for OA, and most treatments focus on relief of symptoms such as pain. Often, the first step is non-medication-based approaches such as physical therapy, exercise, and weight loss. Most patients, however, will eventually use pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs). Other kinds of medication, such as opioids, have also been tested as treatments for OA, and there is ongoing debate abo...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Arthritis Drugs and Supplements Health Osteoarthritis Pain Management Source Type: news
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
This post originally appeared on The Timmerman Report and then ran on Venture Valkyrie. I have a new favorite TV show: Join or Die with Craig Ferguson. Ferguson is a irreverent, sometimes raunchy Scottish comedian who used to host the Late Late Show alongside his skeleton puppet sidekick Geoff.   Join or Die airs Thursdays at 11 pm on the History Channel, which is your first clue that this isn’t your run of the mill late night talk show. The premise of Join or Die, named after Ferguson’s tattoo, is that four people, a random assortment of comedians, actors, historians and scientists plus Ferguson, deb...
Source: Disruptive Women in Health Care - Category: Consumer Health News Authors: Tags: Consumer Health Care Quality Source Type: blogs
It makes sense that the primary goal of pain treatment should be to reduce pain. However, a recent editorial in The New England Journal of Medicine makes a strong case for looking beyond pain intensity when evaluating what is “successful” pain management. The “balancing act” of managing chronic pain Here is the problem: For people with chronic pain, the pain affects nearly all aspects of their lives. But at the same time, treatments to relieve chronic pain also have the potential to influence many aspects of a person’s life. Our best pain-relieving drugs have lots of unpleasant side effects. E...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Health Addiction Arthritis Back Pain Cancer Migraines Pain Management Behavioral Health chronic pain managing pain Source Type: news
I still remember the day as if it were just yesterday. I was sitting in my office across from a patient who came in to see me for his intractable pain. I was covering for another physician, so this patient was new to me. He was wearing a heavy winter coat and sat at the edge of his chair. I asked him to sit back and take his coat off. He said he was in a hurry and wanted his prescription. As I wrote the prescription for methadone, a little voice in my head told me that this encounter was not the way medicine should be practiced. I wanted him to prove to me he needed this strong narcotic. Was he following the lifestyle chan...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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