Attitudes Towards and Management of Opioid-induced Hyperalgesia: A Survey of Chronic Pain Practitioners
Discussion: Most clinicians agreed that OIH is a complication of opioid therapy, but were divided regarding the prevalence of OIH, etiological factors, and optimal management. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - April 7, 2020 Category: Anesthesiology Tags: Original Articles Source Type: research

Efficacy and Safety of Tapentadol Immediate Release for Acute Pain: A Systematic Review and Meta-Analysis
Objective: Tapentadol (TAP) immediate release (IR) is a newer opioid option for acute pain. The aim of this systematic review was to examine the efficacy and safety of TAP IR compared with other opioids for acute pain. Methods: A systematic literature search as conducted using the Cochrane Library, Embase, International Pharmaceutical Abstracts, MEDLINE, PubMed, and Web of Science. The search included all randomized controlled trials and observational studies examining TAP IR versus other orally administered IR opioids for acute pain. The protocol for this study was registered on PROSPERO (CRD42018110267). Results: ...
Source: The Clinical Journal of Pain - April 7, 2020 Category: Anesthesiology Tags: Review Articles Source Type: research

Controlled Release of Oxycodone as an Opioid Titration for Cancer Pain Relief: A Retrospective Study.
Authors: Zhao S, Xu C, Lin R Abstract BACKGROUND In 2014, a Chinese expert consensus was proposed regarding a titration protocol with controlled-release (CR) oxycodone as a background dose for relieving the moderate to severe cancer pain. This work aimed to summarize its efficacy and safety in our hospital. MATERIAL AND METHODS The Good Pain Management (GPM) protocol comprises a CR morphine or oxycodone given every 12-hours as a background dose and an immediate-release (IR) opioid as a rescue dose. Cancer patients with moderate to severe cancer pain were treated with this protocol, and the successful titration (num...
Source: Medical Science Monitor - April 1, 2020 Category: Research Tags: Med Sci Monit Source Type: research

Trends in opioid prescribing in Australia: a systematic review.
Conclusions Australia has experienced a marked increase in opioid prescribing since the 1990s. Current published literature is restricted to incomplete, delayed and historical data, limiting the ability of clinicians and policy makers to intervene appropriately. What is known about the topic? Opioid prescriptions in Australia have continued to increase since the 1990s and may be mirroring the epidemic being seen in the US. What does this paper add? This paper systematically identifies all publications that have examined the prevalence of prescription opioid use in Australia since 2000, and only identified prevalence estima...
Source: Australian Health Review - April 1, 2020 Category: Hospital Management Authors: Donovan PJ, Arroyo D, Pattullo C, Bell A Tags: Aust Health Rev Source Type: research

Scheduled versus as-needed postpartum analgesia and oxycodone utilization
. (Source: Journal of Maternal-Fetal and Neonatal Medicine)
Source: Journal of Maternal-Fetal and Neonatal Medicine - March 20, 2020 Category: Perinatology & Neonatology Authors: Matthew J. Blitz Burton Rochelson Lakha Prasannan Guillaume J. Stoffels Karalyn Pappas Greg T. Palleschi Harvey Marchbein Source Type: research

Effects of oxycodone on sensitivity to reinforcement magnitude: implications for effects of opioids on impulsive and risky choice
The objective of this study was to investigate a potential behavioral mechanism of opioids: a change in the impact of reinforcement magnitude on choice. Rats (n = 7) chose between smaller and larger reinforcers under a continuous-choice (concurrent-chains) procedure. The levers associated with the smaller and larger reinforcers alternated every five sessions. During baseline under this procedure, rats showed a reliable preference for the larger reinforcer. Effects of several doses (0.1–1.7 mg/kg, s.c.) of the prescription opioid, oxycodone, were examined on preference based upon reinforcement magnitude. Oxycodone dos...
Source: Behavioural Pharmacology - March 14, 2020 Category: Drugs & Pharmacology Tags: Research Reports Source Type: research

Effects of oxycodone and diazepam alone and in combination on operant nociception
Developing effective analgesics with fewer unwanted side effects is a pressing concern. Due to a lack of effective nonopioid options currently available, an alternative approach termed opioid-sparing evaluates the ability of a coadministered drug to reduce the amount of opioid needed to produce an antinociceptive effect. Opioids and benzodiazepines are often coprescribed. Although this approach is theoretically rational given the prevalent comorbidity of chronic pain and anxiety, it also has inherent risks of respiratory depression, which is likely responsible for the substantial percentage of fatal opioid overdoses that h...
Source: Behavioural Pharmacology - March 14, 2020 Category: Drugs & Pharmacology Tags: Short Reports Source Type: research

The transversus abdominis plane block reduces the cumulative need of analgesic medication following inguinal hernia repair in TAPP technique: a retrospective single center analysis among 838 patients
AbstractPurposeLaparoscopic inguinal hernia repair (IHR) may lead to early postoperative pain. Therefore, opioid and non-opioid analgesic agents are often administered in the post-anesthesia care unit (PACU). To reduce the postoperative cumulative need of analgesic medication, as well as to accelerate the physical recovery time, the transversus abdominis plane (TAP) block has recently been studied. The TAP block is a regional anesthesia technique. Even though there is evidence about the efficacy of the block used in procedure such as an open inguinal hernia repair, the evidence regarding its use for the TAPP (transabdomina...
Source: Hernia - March 13, 2020 Category: Sports Medicine Source Type: research

The Nature of Suffering, Health Care "Providers," and the Opioid Crisis.
The Nature of Suffering, Health Care "Providers," and the Opioid Crisis. Obstet Gynecol. 2020 Mar 10;: Authors: Wall LL Abstract Over the past 40 years, American medicine has become corporatized. Medical care has become permeated by a business philosophy whose primary concern is increasing shareholder value rather than providing optimal care for patients. Patient-physician relationships have eroded as the health care system has turned its attention toward electronic medical records (rather than face-to-face interactions with patients), toward quantifiable ("billable") metrics, and ...
Source: Obstetrics and Gynecology - March 10, 2020 Category: OBGYN Authors: Wall LL Tags: Obstet Gynecol Source Type: research

Analgesic Effect of Intraoperative Intravenous S-Ketamine in Opioid-Na ïve Patients After Major Lumbar Fusion Surgery Is Temporary and Not Dose-Dependent: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
CONCLUSIONS: Neither a 0.12 nor a 0.6 mg/kg/h infusion of intraoperative IV S-ketamine was superior to the placebo in reducing oxycodone consumption at 48 hours after lumbar fusion surgery in an opioid-naïve adult study population. Future studies should assess ketamine's feasibility in specific study populations who most benefit from reduced opioid consumption. PMID: 32167978 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - March 9, 2020 Category: Anesthesiology Authors: Brinck ECV, Maisniemi K, Kankare J, Tielinen L, Tarkkila P, Kontinen VK Tags: Anesth Analg Source Type: research

Erector spinae-plane block as an analgesic alternative in patients undergoing mitral and/or tricuspid valve repair through a right mini-thoracotomy - an observational cohort study.
Conclusions: The ESP block seems to be safe and efficient for pain control in patients undergoing right mini-thoracotomy for mitral and/or tricuspid valve repair. PMID: 32117506 [PubMed] (Source: Videosurgery and Other Miniinvasive Techniques)
Source: Videosurgery and Other Miniinvasive Techniques - March 3, 2020 Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research

44: Oxycodone use during the post-operative period after hysterectomy for benign indications
To evaluate whether oxycodone use for postoperative pain control after hysterectomy for benign disease differs based on hysterectomy route. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - February 28, 2020 Category: OBGYN Authors: J.M. Miranne, T. Abdalian, I. Gabriel, S. Cohen, M. Ajao, J. Einarsson, V. Minassian Tags: Non-Oral Poster Source Type: research

Preclinical Assessment of the Analgesic Pharmacology of NKTR-181 in Rodents.
CONCLUSIONS: NKTR-181 had a slower onset, but similar efficacy, to morphine in the models studied supporting reduced abuse potential while maintaining analgesic effect in comparison with current opioids. PMID: 32107752 [PubMed - as supplied by publisher] (Source: Cellular and Molecular Neurobiology)
Source: Cellular and Molecular Neurobiology - February 27, 2020 Category: Cytology Authors: Kopruszinski CM, Swiokla J, Lee YS, Navratilova E, VanderVeen L, Yang M, Liu Y, Miyazaki T, Schmidt WK, Zalevsky J, Porreca F Tags: Cell Mol Neurobiol Source Type: research

Determination of structural factors affecting binding to mu, kappa and delta opioid receptors.
Abstract Addiction is a complex behavioral phenomenon in which naturally occurring or synthetic chemicals modulate the response of the reward system through their binding to a variety of neuroreceptors, resulting in compulsive substance-seeking and use despite harmful consequences to the individual. Among these, the opioid receptor (OR) family and more specifically, the mu-opioid receptor (MOR) subtype plays a critical role in the addiction to powerful prescription and illicit drugs such as hydrocodone, oxycodone, fentanyl, cocaine, and methamphetamine (Contet et al. in Curr Opin Neurobiol 14(3):370-378, 2004). Co...
Source: Archives of Toxicology - February 27, 2020 Category: Toxicology Authors: Slavov S, Mattes W, Beger RD Tags: Arch Toxicol Source Type: research

Patterns of heroin use following index prescription opioid exposure.
CONCLUSIONS: This study further supports the role that prescription opioids play in the transition to heroin use. It suggests that oxycodone is the most common prescription opioid used prior to heroin initiation. Additionally, it reports descriptive information as to how and where prescription opioids are obtained. PMID: 32091617 [PubMed - as supplied by publisher] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - February 26, 2020 Category: Addiction Tags: J Opioid Manag Source Type: research

Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain.
Abstract Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be ...
Source: Pain Research and Management - February 25, 2020 Category: Anesthesiology Authors: Wang Y, Xing L Tags: Pain Res Manag Source Type: research

In a rat model of opioid maintenance, the G-protein-biased MOR agonist TRV130 decreases relapse to oxycodone seeking and taking, and prevents oxycodone-induced brain hypoxia
Maintenance treatment with opioid agonists (buprenorphine, methadone) is effective for opioid addiction but does not eliminate opioid use in all patients. Here, we modeled maintenance treatment in rats that self-administered the prescription opioid oxycodone. The maintenance medication was either buprenorphine or the G-protein-biased mu opioid receptor (MOR) agonist TRV130. We then tested prevention of oxycodone seeking and taking during abstinence using a modified context-induced-reinstatement procedure, a rat relapse model. (Source: Biological Psychiatry)
Source: Biological Psychiatry - February 24, 2020 Category: Psychiatry Authors: Jennifer M. Bossert, Eugene Kiyatkin, Hannah Korah, Jennifer K. Hoots, Anum Afzal, David Perekopskiy, Shruthi Thomas, Ida Fredriksson, Bruce E. Blough, S. Stevens Negus, David H. Epstein, Yavin Shaham Tags: Archival Report Source Type: research

Oxycodone Decreases Dendritic Complexity in Female but not Male Rat Striatal Neurons In Vitro
Publication date: Available online 20 February 2020Source: Neuroscience LettersAuthor(s): Sara A. Wlodarczyk-Li, Fair M. Vassoler, Elizabeth M. Byrnes, Christopher M. SchonhoffAbstractThe use of oxycodone in the past two decades has dramatically risen, yet the amount of research regarding how it impacts neuronal health is lacking. As prescription use and misuse in women of reproductive age increases there has been a corresponding increase in the number of infants who have been exposed to oxycodone in utero. Given the critical role of the striatum in motor control and reward regulation, the aim of the current study was to e...
Source: Neuroscience Letters - February 21, 2020 Category: Neuroscience Source Type: research

Variability in opioid prescribing following fracture fixation: A retrospective cohort analysis
Background: We quantified variability in opioid prescriptions for orthopaedic trauma patients at an academic level 1 trauma center and examined patient, prescriber, and injury factors associated with prescription practices. Methods: Patients with malleolar, diaphyseal tibia, plateau, proximal femur, and forearm fractures at a level 1 trauma center were identified retrospectively. The number of opioid pills prescribed at discharge, demographics, and prescriber (MD vs. APP) data were collected. Statistical analysis was done to compare opioid prescription with injury location, patient, and prescriber data. Multivariate l...
Source: Current Orthopaedic Practice - February 21, 2020 Category: Orthopaedics Tags: Special Focus: Trauma Source Type: research

Managing opioid consumption after caesarean delivery: a quality improvement initiative
AbstractIntroductionCaesarean delivery is the most common major surgical procedure performed worldwide and pain management after caesarean delivery remains challenging. Finding a balance between sufficient postoperative pain relief and excess sedation secondary to opioids is often difficult in this patient population. This quality improvement project aimed to manage the amount of opioid consumption after caesarean delivery using a new postoperative analgesic regimen.MethodsThe current practice was analysed in 52 patients before introducing the new regimen. Oxycodone consumption, pain scores and quality of recovery were rec...
Source: Irish Journal of Medical Science - February 11, 2020 Category: General Medicine Source Type: research

Effect of Over the Counter Ibuprofen Dosing after Sinus Surgery for Chronic Rhinosinusitis: A Prospective Cohort Pilot Study.
CONCLUSIONS: Over the counter dosing of ibuprofen along with acetaminophen may yield better pain control after sinus surgery compared to acetaminophen alone. Additionally, there was no significant difference in epistaxis in the ibuprofen cohort compared to the cohort who did not take ibuprofen. Furthermore, this study showed very few opioid pills were consumed after routine ESS regardless of pain regimen prescribed. A larger trial is needed to make definitive statements on safety and efficacy. LEVEL OF EVIDENCE: 2b. PMID: 32028782 [PubMed - as supplied by publisher] (Source: The Annals of Otology, Rhinology, and Laryngology)
Source: The Annals of Otology, Rhinology, and Laryngology - February 6, 2020 Category: ENT & OMF Authors: Miller C, Humphreys IM, Davis GE Tags: Ann Otol Rhinol Laryngol Source Type: research

Overprescribing of Opioids to Adults by Dentists in the U.S., 2011–2015
ConclusionsBetween 1 in 4 and 1 in 2 opioids prescribed to adult dental patients are overprescribed. Judicious opioid-prescribing interventions should be tailored to oral health conditions and dentists. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - February 5, 2020 Category: International Medicine & Public Health Source Type: research

Prolonged-Release (PR) Oxycodone/Naloxone Improves Bowel Function Compared with Oxycodone PR and Provides Effective Analgesia in Chinese Patients with Non-malignant Pain: A Randomized, Double-Blind Trial
AbstractIntroductionProlonged-release oxycodone/naloxone (OXN PR), combining an opioid analgesic with selective blockade of enteric µ-opioid receptors, provided effective analgesia and improved bowel function in patients with moderate-to-severe pain and opioid-induced constipation in clinical trials predominantly conducted in Western countries. This double-blind randomized controlled trial investigated OXN PR (N = 116) versus prolonged-release oxycodone (OXY PR,N = 115) for 8 weeks at doses up to 50 mg/day in patients with moderate-to-severe, chronic, non-malignant musculoskeleta...
Source: Advances in Therapy - February 3, 2020 Category: Drugs & Pharmacology Source Type: research

Oxycodone preemptive analgesia after endoscopic plasma total adenotonsillectomy in children: A randomized controlled trial
Background: Endoscopic tonsillectomy is associated with postoperative pain. Postoperative pain management remains to be improved in children. We aimed to investigate oxycodone preemptive analgesia in children undergoing endoscopic plasma total adenotonsillectomy. Methods: 166 children with adenotonsillar hypertrophy were recruited at Wuhan Children's Hospital between 08/2016 and 03/2017. They were randomly assigned to receive SPOA (postoperative sufentanil), SPEA+SPOA (preemptive sufentanil and postoperative sufentanil), and OPEA+SPOA (preemptive oxycodone and postoperative sufentanil). The primary endpoint was serum ...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Long-term effect of oxycodone/naloxone on the management of post-operative pain after hysterectomy: a randomised prospective study.
CONCLUSIONS: Improved pain control, bowel function and reduced side effects were observed with OXN compared to morphine in patients who underwent hysterectomy. PMID: 31994365 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)
Source: Minerva Anestesiologica - January 31, 2020 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

Kappa opioid agonists reduce oxycodone self-administration in male rhesus monkeys
ConclusionsThese results demonstrate that KOR agonists, including the clinically used KOR agonist, nalfurafine, can punish self-administration of a prescription opioid analgesic, oxycodone, in rhesus monkeys and that nalfurafine ’s punishing effect is KOR-dependent. Combinations of KOR agonists with prescription opioids may have reduced abuse liability. (Source: Psychopharmacology)
Source: Psychopharmacology - January 31, 2020 Category: Psychiatry Source Type: research

Developing an animal model to detect drug–drug interactions impacting drug-induced respiratory depression
In this study, diazepam was selected as the benzodiazepine to detect any additive or synergistic effects on respiratory depression caused by the opioid, oxycodone. Pharmacokinetic studies were conducted at three doses with oxycodone (6.75, 60, 150 mg/kg) and with diazepam (2, 20, 200 mg/kg). Dose dependent decrease in arterial partial pressure of oxygen and increase in arterial partial pressure of carbon dioxide were observed with oxycodone. Diazepam caused similar partial pressure changes only at the highest dose. Further decreases in arterial partial pressure of oxygen and increases in arterial partial pressure of ca...
Source: Toxicology Reports - January 30, 2020 Category: Toxicology Source Type: research

Desmetramadol Is Identified as a G-Protein Biased µ Opioid Receptor Agonist
Tramadol is widely used globally and is the second most prescribed opioid in the United States. It treats moderate to severe pain but lethal opioid-induced respiratory depression is uncommon even in large overdose. It is unknown why tramadol spares respiration. Here we show its active metabolite, desmetramadol, is as effective as morphine, oxycodone and fentanyl in eliciting G protein coupling at the human µ opioid receptor (MOR), but surprisingly, supratherapeutic concentrations spare human MOR-mediated βarrestin2 recruitment thought to mediate lethal opioid-induced respiratory depression. (Source: Frontiers in Pharmacology)
Source: Frontiers in Pharmacology - January 30, 2020 Category: Drugs & Pharmacology Source Type: research

Nociceptin attenuates the escalation of oxycodone self-administration by normalizing CeA-GABA transmission in highly addicted rats [Neuroscience]
Approximately 25% of patients who are prescribed opioids for chronic pain misuse them, and 5 to 10% develop an opioid use disorder. Although the neurobiological target of opioids is well known, the molecular mechanisms that are responsible for the development of addiction-like behaviors in some but not all individuals are... (Source: Proceedings of the National Academy of Sciences)
Source: Proceedings of the National Academy of Sciences - January 28, 2020 Category: Science Authors: Marsida Kallupi, Lieselot L. G. Carrette, Jenni Kononoff, Leah C. Solberg Woods, Abraham A. Palmer, Paul Schweitzer, Olivier George, Giordano de Guglielmo Tags: Biological Sciences Source Type: research

Female and male rats readily consume and prefer oxycodone to water in a chronic, continuous access, two-bottle oral voluntary paradigm.
Abstract The increasing abuse of opioids - such as oxycodone - poses major challenges for health and socioeconomic systems. Human prescription opioid abuse is marked by chronic, voluntary, oral intake and sex differences. To develop interventions, the field would benefit from a preclinical paradigm that similarly provides rodents with chronic, continuous, oral, voluntary and free-choice access to oxycodone. Here we show female and male rats voluntarily ingest and choose oxycodone over water and show both dependence and motivation to take oxycodone during a chronic oral voluntary, two-bottle choice, continuous acce...
Source: Neuropharmacology - January 27, 2020 Category: Drugs & Pharmacology Authors: Zanni G, DeSalle MJ, Deutsch HM, Barr GA, Eisch AJ Tags: Neuropharmacology Source Type: research

Developing an Animal Model to Detect Drug-Drug Interactions Impacting Drug-Induced Respiratory Depression
In this study, diazepam was selected as the benzodiazepine to detect any additive or synergistic effects on respiratory depression caused by the opioid, oxycodone. Pharmacokinetic studies were conducted at three doses with oxycodone (6.75, 60, 150 mg/kg) and with diazepam (2, 20, 200 mg/kg). Dose dependent decrease in arterial partial pressure of oxygen and increase in arterial partial pressure of carbon dioxide were observed with oxycodone. Diazepam caused similar partial pressure changes only at the highest dose. Further decreases in arterial partial pressure of oxygen and increases in arterial partial pres...
Source: Toxicology Reports - January 26, 2020 Category: Toxicology Source Type: research

Alleviation of Pain After Femur and Tibia Shaft Fractures Using Nothing Stronger Than Codeine and Tramadol
Conclusions: Alleviation of pain can be achieved in most patients with femoral and tibial shaft fractures, including multiply injured patients, with one-on-one patient support and by using nothing stronger than codeine and tramadol. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - January 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

In vitro profiling of opioid ligands using the cAMP formation inhibition assay and the β-arrestin2 recruitment assay: No two ligands have the same profile.
In vitro profiling of opioid ligands using the cAMP formation inhibition assay and the β-arrestin2 recruitment assay: No two ligands have the same profile. Eur J Pharmacol. 2020 Jan 25;:172947 Authors: Kuo A, Magiera J, Rethwan N, Andersson Å, Leen Lam A, Wyse B, Meutermans W, Lewis R, Smith M Abstract Previously, we showed that no two of seven opioids administered by the intracerebroventricular route had the same potency rank order for evoking antinociception, constipation and respiratory depression in rats. To gain insight at the cellular level, this study was designed to systematically i...
Source: European Journal of Pharmacology - January 25, 2020 Category: Drugs & Pharmacology Authors: Kuo A, Magiera J, Rethwan N, Andersson Å, Leen Lam A, Wyse B, Meutermans W, Lewis R, Smith M Tags: Eur J Pharmacol Source Type: research

Opioid prescription use in patients with interstitial cystitis
ConclusionsA significant number of patients with IC are treated with opioids. Although the overall number of opioid prescriptions associated with IC had declined, the prescription rate per IC diagnosis had not. As part of the national initiative to reduce opioid use, our data suggest that IC treatment strategies should be examined. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - January 24, 2020 Category: OBGYN Source Type: research

Adjunctive effect of the serotonin 5-HT2C receptor agonist lorcaserin on opioid-induced antinociception in mice.
eso J Abstract Opioid-sparing adjuncts are treatments that aim to reduce the overall dose of opioids needed to achieve analgesia, hence decreasing the burden of side effects through alternative mechanisms of action. Lorcaserin is a serotonin 5-HT2C receptor (5-HT2CR) agonist that has recently been reported to reduce abuse-related effects of the opioid analgesic oxycodone. The goal of our studies was to evaluate the effects of adjunctive lorcaserin on opioid-induced analgesic-like behavior using the tail-flick reflex (TFR) test as a mouse model of acute thermal nociception. We show that whereas subcutaneous (s.c.) ...
Source: Neuropharmacology - January 24, 2020 Category: Drugs & Pharmacology Authors: Sierra S, Lippold KM, Stevens DL, Poklis JL, Dewey WL, González-Maeso J Tags: Neuropharmacology Source Type: research

The effect of surgical pain severity, preoperative opioid use and patient characteristics on postoperative opioid prescriptions and refills in orthopedic surgery
AbstractBackgroundExcessive opioid prescriptions after orthopedic surgery are common. The purpose of this study was to examine the association between surgical severity, preoperative opioid use and patient characteristics with postoperative opioid prescriptions and refills.MethodsSeventy-nine patients undergoing orthopedic surgeries were reviewed. Surgical pain severity was categorized as mild (n  =  25), moderate (n  =  26) and severe (n  =  28). Patients were also categorized as opioid naïve (n  =  57), experienced (n  =  16) and tolerant (n &thin...
Source: European Journal of Orthopaedic Surgery and Traumatology - January 23, 2020 Category: Orthopaedics Source Type: research

Carbonyl-protein content increases in brain and blood of female rats after chronic oxycodone treatment
Opioids are the most effective drugs commonly prescribed to treat pain. Due to their addictive nature, opioid pain relievers are now second to marijuana, ahead of cocaine with respect to dependence. Ours and o... (Source: BMC Neuroscience)
Source: BMC Neuroscience - January 22, 2020 Category: Neuroscience Authors: Ruping Fan, Lisa M. Schrott, Stephen Snelling, John Felty, Derrel Graham, Patrick L. McGauly, Thomas Arnold and Nadejda L. Korneeva Tags: Research article Source Type: research

Oxycodone suppresses the lipopolysaccharide-induced neuroinflammation by downregulating nuclear factor-κB in hippocampal astrocytes of Sprague–Dawley rats
Neuroinflammation is a common pathogenic mechanism in several neurodegenerative diseases, and glial cells are the primary inflammatory mediators of the central nervous system (CNS). Acute neuronal injury, infection, and chronic neurodegeneration may induce astrocyte activation, which is a response characterized by hyperproliferation and release of multiple inflammatory signaling factors. The opioid analgesic oxycodone has demonstrated anti-inflammatory efficacy in peripheral tissue, but its effects on the CNS have not been studied. We evaluated the inhibitory effects of oxycodone on astrocyte activation and proinflammatory...
Source: NeuroReport - January 15, 2020 Category: Neurology Tags: Cellular, Molecular and Developmental Neuroscience Source Type: research

Rapid Induction of Buprenorphine/Naloxone for Chronic Pain Using a Microdosing Regimen: A Case Report
We present the case of a 66-year-old woman with inadequately controlled postoperative pain despite escalating doses of oxycodone and methadone, who was successfully transitioned to buprenorphine/naloxone using a rapid microinduction technique without precipitating opioid withdrawal. Rapid induction provides an alternative method for transitioning patients from other opioids to buprenorphine/naloxone and facilitates transition of patients with chronic pain to buprenorphine therapy within a shorter window compared to currently existing protocols. (Source: A&A Case Reports)
Source: A&A Case Reports - January 15, 2020 Category: Anesthesiology Tags: Case Reports Source Type: research

Efficacy of EUS-guided celiac plexus neurolysis compared with medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era: A prospective randomized control study
The efficacy of celiac plexus neurolysis (CPN) with EUS guidance has not been confirmed in the era of developed opioids. The aim of this study was to evaluate the efficacy of EUS-guided CPN (EUS-CPN) for patients with pancreatic cancer-associated pain to compare medication using oxycodone and/or fentanyl with and without EUS-CPN. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - January 14, 2020 Category: Gastroenterology Authors: Yoshihide Kanno, Shinsuke Koshita, Kaori Masu, Takahisa Ogawa, Hiroaki Kusunose, Toji Murabayashi, Toshitaka Sakai, Fumisato Kozakai, Kei Ito Source Type: research

En kvinne i 40- årene som brukte vanedannende legemidler i svært høye doser.
En kvinne i 40-årene som brukte vanedannende legemidler i svært høye doser. Tidsskr Nor Laegeforen. 2020 Jan 14;140(1): Authors: Heldal AT, Aamo TO, Frost J Abstract BACKGROUND: Following a surgical procedure, a female patient in her forties was prescribed opioids (oxycodone). The prescription escalated into doses that were extremely high, and at a level beyond any experienced previously, either at the various hospital units that were involved in the treatment or in the medical literature. CASE PRESENTATION: The patient had no known history of substance abuse. After the surgica...
Source: Tidsskrift for den Norske Laegeforening - January 14, 2020 Category: General Medicine Authors: Heldal AT, Aamo TO, Frost J Tags: Tidsskr Nor Laegeforen Source Type: research

Efficacy of EUS-guided celiac plexus neurolysis compared with  medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era: a prospective randomized control study
The efficacy of celiac plexus neurolysis (CPN) with EUS guidance (EUS-CPN) has not been confirmed in the era of developed opioids. The aim of this study was to evaluate the efficacy of EUS-CPN for patients with pancreatic cancer –associated pain to compare medication using oxycodone and/or fentanyl with and without EUS-CPN. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - January 14, 2020 Category: Gastroenterology Authors: Yoshihide Kanno, Shinsuke Koshita, Kaori Masu, Takahisa Ogawa, Hiroaki Kusunose, Toji Murabayashi, Toshitaka Sakai, Fumisato Kozakai, Kei Ito Tags: Original article Source Type: research

Opioid-Prescribing Practices in Plastic Surgery: A Juxtaposition of Attendings and Trainees
AbstractBackgroundThe rates of opioid abuse and overdose in America have risen in parallel with the rates of opioid prescribing by physicians. As such, we sought to examine the prescribing practices among plastic surgery attendings and trainees to determine the need for more thorough education.MethodsA survey was distributed to all ACGME-accredited plastic surgery residency programs and included questions regarding opioid-prescribing practices and self-rated ability pertaining to opioid management. Trends in prescribing practices based on prescriber position were analyzed using cumulative odds ordinal logistic regression w...
Source: Aesthetic Plastic Surgery - January 6, 2020 Category: Cosmetic Surgery Source Type: research

Effects of Adding Oxycodone to Ropivacaine on Labor Analgesia: A Randomized Controlled Trial
Conclusions: This study demonstrates that epidural oxycodone may accelerate the onset of analgesia and obviously prolong the duration of analgesia during labor without increasing adverse effects associated with the neonate. However, it may cause a higher incidence of maternal pruritus (registration number: ChiCTR1800016483). (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 3, 2020 Category: Anesthesiology Tags: Original Articles Source Type: research

Organophotocatalytic N-Demethylation of Oxycodone using Molecular Oxygen.
Abstract N -Demethylation of oxycodone is one of the key steps in synthesis of important opioid antagonists like naloxone or analgesics like nalbuphine. The reaction is typically carried out using stoichiometric amounts of toxic and corrosive reagents. Herein we present a green and scalable organophotocatalytic procedure that accomplishes the N -demethylation step using molecular oxygen as the terminal oxidant and an organic dye (rose bengal) as effective photocatalyst. Optimization of the reaction conditions under continuous flow conditions using visible-light irradiation led to an efficient, reliable and scalabl...
Source: Chemistry - January 3, 2020 Category: Chemistry Authors: Chen Y, Glotz G, Cantillo D, Kappe CO Tags: Chemistry Source Type: research

Pharmacovigilance in Hospice/Palliative Care: De-Prescribing Combination Controlled Release Oxycodone-Naloxone
Journal of Palliative Medicine, Ahead of Print. (Source: Journal of Palliative Medicine)
Source: Journal of Palliative Medicine - January 3, 2020 Category: Palliative Care Authors: Katherine Clark Paul G. Byrne Jane Hunt Linda Brown Debra Rowett Gareth Watts Melanie Lovell David C. Currow Source Type: research

A Prospective Randomized Trial of an Oral Patient-Controlled Analgesia Device Versus Usual Care Following Total Hip Arthroplasty
CONCLUSION: Patients using the wireless patient-controlled analgesia (PCA) (oral) device had less pain at rest and with activity (men) while taking lower doses of oxycodone with each dose. Nursing surveys indicated that nursing staff in this orthopedic postoperative unit found the device easy to use, reliable, and efficient. They also recommended its adoption for those capable of using it. (Source: Orthopaedic Nursing)
Source: Orthopaedic Nursing - January 1, 2020 Category: Nursing Tags: Original Articles Source Type: research

828: Optimizing post-cesarean opioid prescription practices: a quality improvement initiative
Optimal prescriptions practices of opioids in the post-cesarean period remain controversial. The primary aim of this initiative was to minimize unused prescription narcotic medication, with a goal of ≤ 4 leftover pills of 5mg oxycodone at postoperative day (POD) 14 without affecting pain or satisfaction measures. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - December 31, 2019 Category: OBGYN Authors: Pavan Parikh, Sharon Kim, Ajleeta Sangtani, Amanda King, Sherif Shazly, Matthew Hathcock, Shanna Rapp, Angela Thompson Tags: Poster Session IV Source Type: research

Corrigendum to “Comparing cost and effectiveness of IVPCA morphine with perioperative multimodal analgesia of oral etoricoxib and oxycontin: A retrospective study” [J Orthop 16 (2019) 585-589]
Publication date: Available online 28 December 2019Source: Journal of OrthopaedicsAuthor(s): Pik Yu Chen, Winnie Samy, Chee Lun Aaron Ying (Source: Journal of Orthopaedics)
Source: Journal of Orthopaedics - December 30, 2019 Category: Orthopaedics Source Type: research