Neuromodulation With Burst and Tonic Stimulation Decreases Opioid Consumption: A Post Hoc Analysis of the Success Using Neuromodulation With BURST (SUNBURST) Randomized Controlled Trial

AbstractObjectiveThe SUNBURST study was a prospective, multicenter, randomized crossover trial of a single device delivering burst and tonic spinal cord stimulation (SCS) for chronic trunk and/or limb pain. We performed apost hoc analysis of opioid consumption at baseline and after device implantation.Materials and MethodsAfter implantation, 100 patients were randomized to one mode (tonic or burst) for 12  weeks, and the other mode for the subsequent 12 weeks. After the crossover period (24 weeks), patients chose their preferred mode and were assessed for one year. We analyzed 69 patients who took opioid medication at baseline. The primary endpoint was opioid consumption in morphine milligram e quivalents (MMEs) at baseline and 12 months postimplantation. Subgroup analysis included opioid consumption based on Center for Disease Control markers (120  MME/day) and stimulation mode preference.ResultsOpioid consumption at 12  months was lower compared to baseline (53.94 vs. 79.19 MME, MD −25.25, 95% CI −43.77 to 6.73,p = 0.008). By 12  months, 11 of 69 patients (15.9%) discontinued all opioid (p = 0.001). Based on CDC dose markers, the proportion of patients taking>120  MME/day decreased by 61.7% at 12 months postintervention compared to baseline (p = 0.043). Forty ‐five of 69 patients (65.2%) preferred burst SCS while 15 of 69 patients (21.7%) preferred tonic SCS (p 120  MME/day)...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research

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We present the case of a 62-year-old woman arriving to the emergency department (ED) with a chief complaint of intractable vomiting after ingestion of kratom. After a day of yard work, she was in pain, secondary to her osteoporotic joints. She was recommended kratom from a family member, who stated he was using kratom to transition away from opioid dependence. She took two “scoops.” She proceeded to have multiple episodes of vomiting at home. She came to the ED, where she required multiple rounds of anti-emetic medication for resolution of her symptoms.DiscussionWe present a classic case of a novel acute toxici...
Source: International Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
AbstractPurpose of ReviewThe purpose of this narrative review is to inform readers of the particular impact opioids have had on midlife women and to provide perspective on non-opioid treatment options for women with chronic low back pain.Recent FindingsResearch has shown that midlife women experience more chronic low back pain than men and other age groups of women. As a result, opioids have been particularly deleterious in this demographic group. In addition, there are no data to recommend them for long-term use, while there is a breadth of data on the negative consequences of long-term opioid use. Treatment guidelines no...
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research
By ANDY MYCHKOVSKY In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit! 1. Epic Systems Corporation The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Po...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech Health Technology Start-Ups Andy Mychkovsky Healthcare Pizza Innovation Startups Source Type: blogs
Cliffside Malibu does not condone the use of the term “addict” when referring to people suffering from the disorder of addiction. However, we do understand that others still may use the term in order to find information. Many people may find themselves asking the question, “am I an opioid addict?” if they feel as if their use has spiraled out of control. There are many ways to find out if you may have become addicted to opioids, as well as ways to get help and find treatment. How Opioid Addiction Begins Nearly 80% of heroin users started with prescription opioids, which puts prescription drugs and ...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction to Pharmaceuticals addiction treatment opioid opioid crisis opioids pharmaceutical addiction pharmaceutical drug abuse treatment Source Type: blogs
This article represents the findings from the queries over the first three months ’ queries and brings further clarity to our initial findings.Methods This quality improvement (QI) project was reviewed and approved by the Orlando Health/UFHealth Cancer Center Joint Oncology Committee for 2018-19. We began recording results of all E-FORSCE queries occurring after the law ’s implementation of July 1, 2018 through September 30, 2018. We informed each patient that the PDMP query had become mandatory in Florida, and we discussed the results of each query with each patient. Each query examined the last 12 months of t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: kollas opioid pain quality improvement statte Source Type: blogs
What is the Definition of “Opioid”? The definition of opioid is as follows: Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others. Opioids work by interacting with the opioid receptors on nerve cells in the body and brain. By interacting with these receptors, opioids medications are able to cut off communication between the pain point on the body to the brain. This chemical interaction gives it’s users pain relief that is too great for ov...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction to Pharmaceuticals fentanyl heroin heroin addiction opiate opiate abuse opiate addiction opiates opioid opioids Source Type: blogs
Over the past two decades, the federal and state governments, industry, and professionals have taken significant actions to address opioid abuse, addiction, and overdose, including efforts to determine the appropriateness of prescribing opioid analgesics to patients with acute and chronic pain (Greene, et  al., 2018; Jones, et al., 2018). Without a doubt, many of these efforts have been necessary. Some measures, however, have focused sharply on reducing the supply of prescription opioids, which has contributed toward confusion and fear among prescribers and restricted access to controlled prescript ion medication...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Editorial Source Type: research
by Drew Rosielle (@drosielle)This is the second in a series of several posts about many aspects of my current thinking about opioids.The first post is here:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Over-prescribing fueled the current drug overdose epidemic, and many of us who thought we were stamping out needless suffering contributed to the epidemic.A lot of what I read and believed about opioids early on in my career was wrong.I ’m old enough to remember those heady days in which there was a pretty large and ‘successful’ movement in American medicine to gr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
Back in May, Bruce Schoneboom wrapped up his appointment to the HHS Pain Management Best Practices Inter-Agency Task Force. The group determined best practices for managing chronic and acute pain—and addressed judicious prescribing of opioids. If you didn’t know: The CDC reports there are 192 overdose deaths in the U.S. every day. Forty percent of The post Dr. Bruce Schoneboom and the HHS Pain Task Force appeared first on Johns Hopkins Nursing Magazine.
Source: Nursing Blogs at Johns Hopkins University - Category: Nursing Authors: Tags: New On the Pulse DNP nurse anesthesiology nurse anesthetist pain month Source Type: blogs
For more than a century, clinicians have noticed a paradoxical phenomenon: certain patients who are taking opioids (which are supposed to numb pain) become more sensitive to pain than those who are not taking opioids. The earliest observation of this phenomenon can be traced back to the British physician Sir Clifford Allbutt, who, in 1870, described it: “at such times I have certainly felt it a great responsibility to say that pain, which I know is an evil, is less injurious than morphia, which may be an evil. Does morphia tend to encourage the very pain it pretends to relieve?” Research studies and clinical ob...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Pain Management Source Type: blogs
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