Nonpharmacologic and Pharmacologic Management of Acute Pain From Non-Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians.
Abstract
DESCRIPTION: The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) developed this guideline to provide clinical recommendations on nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults in the outpatient setting. The guidance is based on current best available evidence about benefits and harms, taken in the context of costs and patient values and preferences. This guideline does not address noninvasive treatment of low back pain, which is covered by a separate ACP guideline that has also been endorsed by...
Source: Annals of Internal Medicine - August 17, 2020 Category: Internal Medicine Authors: Qaseem A, McLean RM, O'Gurek D, Batur P, Lin K, Kansagara DL Tags: Ann Intern Med Source Type: research
Management of Acute Pain From Non-Low Back Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials.
CONCLUSION: Topical NSAIDs, followed by oral NSAIDs and acetaminophen with or without diclofenac, showed the most convincing and attractive benefit-harm ratio for patients with acute pain from non-low back musculoskeletal injuries. No opioid achieved benefit greater than that of NSAIDs, and opioids caused the most harms.
PRIMARY FUNDING SOURCE: National Safety Council. (PROSPERO: CRD42018094412).
PMID: 32805127 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - August 17, 2020 Category: Internal Medicine Authors: Busse JW, Sadeghirad B, Oparin Y, Chen E, Goshua A, May C, Hong PJ, Agarwal A, Chang Y, Ross SA, Emary P, Florez ID, Noor ST, Yao W, Lok A, Ali SH, Craigie S, Couban R, Morgan RL, Culig K, Brar S, Akbari-Kelachayeh K, Pozdnyakov A, Shergill Y, Sivananthan Tags: Ann Intern Med Source Type: research
Synergistic Antinociceptive Activity of Tramadol/Acetaminophen Combination Mediated by μ-Opioid Receptors.
Abstract
We investigated whether tramadol could suppress both neuropathic and inflammatory pain in mice at the same dose level. We also examined the effects of drugs metabolized by glucuronidase, such as acetaminophen (ACAP), indomethacin, probenecid, and valproate, on the antinociceptive activity of tramadol. The administration of 5.6 or 10 mg/kg tramadol suppressed cuff-induced mechanical allodynia, but 10 mg/kg tramadol did not suppress complete Freund's adjuvant (CFA)-induced mechanical allodynia. Although neither tramadol (10 mg/kg) nor ACAP (100 mg/kg) alone produced an antinociceptive effect...
Source: Biological and Pharmaceutical Bulletin - July 3, 2020 Category: Drugs & Pharmacology Authors: Yoshizawa K, Arai N, Suzuki Y, Fujita A, Takahashi Y, Kawano Y, Hanawa T Tags: Biol Pharm Bull Source Type: research
Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster: A case report
Rationale:
Herpes zoster (HZ) involving sacral dermatome is very rare, which can sometimes cause voiding dysfunction.
Patient concerns:
A 52-year-old man presented with acute pain and voiding dysfunction, following HZ in his right sacral dermatomes.
Diagnoses:
Twenty two days before presentation HZ occurred and 9 days after the onset of the HZ, he had trouble with starting urination and weak urine stream which was managed with tamsulosin 0.4 mg orally once a day and intermittent urinary catheterization. He was treated with 150 mg of pregabalin 2 times a day, tramadol 50 mg 2 times, and acetaminophen 600 mg ...
Source: Medicine - June 19, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Assessment and Management of Postoperative Pain Associated with Sleep Apnea Surgery
A literature review was conducted regarding the assessment and treatment of postoperative pain following surgery for obstructive sleep apnea (OSA). Given the risks of opioid use by patients with OSA, special attention to opioid risk reduction and avoidance is warranted in this population. The results of this review demonstrate the existence of a body of evidence that supports the use of nonopioid analgesics and nonpharmacologic approaches pain management. Strategies for managing postoperative pain should emphasize the use of local anesthetic infiltration, nonsteroidal antiinflammatory drugs, acetaminophen, topical analgesi...
Source: Otolaryngologic clinics of North America - June 17, 2020 Category: ENT & OMF Authors: Jonathan A. Waxman, Kerolos G. Shenouda, Ho-Sheng Lin Source Type: research
Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006-2017.
This report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006-2007 through 2016-2017, by selected patient and hospital characteristics and the type of opioids prescribed. Methods-Data are from the 2006-2017 National Hospital Ambulatory Medical Care Survey. The study population included all ED visits by patients aged 18 and over. The main outcome studied was opioids prescribed at ED discharge, defined using Cerner Multum's third-level therapeutic category codes for narcotic analgesics (Code 60) and narcotic-analgesic combinations (Code 191). Results-The percentage of ED vis...
Source: National health statistics reports - June 10, 2020 Category: American Health Tags: Natl Health Stat Report Source Type: research
Rapid Sol Gel Synthesis of BaFe12O19 Nanoparticles: An Excellent Catalytic Application in the Electrochemical Detection of Tramadol in the Presence of Acetaminophen
Publication date: Available online 9 March 2020Source: Microchemical JournalAuthor(s): Zoheira Bagherinasab, Hadi Beitollahi, Mohammad Yousefi, Mojtaba Bagherzadeh, Malak Hekmati (Source: Microchemical Journal)
Source: Microchemical Journal - April 23, 2020 Category: Chemistry Source Type: research
Effect of scheduled intravenous acetaminophen on postoperative nausea and vomiting in patients undergoing laparoscopic gynecologic surgery
ConclusionIntroduction of SIVA into the postoperative pain management protocol of LGS may reduce the incidence of PONV and the amount of adjunctive antiemetic medication required from postoperative days 0 to 1. In patients undergoing LGS, PONV prophylaxis using antiemetics should be prescribed depending on PONV risk profile; however, SIVA prophylaxis can be used in all patients regardless of PONV risk profile. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 16, 2020 Category: Anesthesiology Source Type: research
Pitfalls of toxicological investigations in hair, bones, and nails in extensively decomposed bodies: illustration with two cases
AbstractIt is difficult to carry out toxicological investigations in biological samples collected from extensively decomposed bodies and to interpret obtained results as several pitfalls should be considered: redistribution phenomena, degradation of xenobiotics during thepostmortem period, contamination by putrefaction fluids, and external contamination. This work aims to present two cases in order to illustrate and discuss these difficulties in this tricky situation. Case#1: the body of a 30-year-old woman was found in a wooded area (1 month after she has been reported missing by her family): hair and a femur section we...
Source: International Journal of Legal Medicine - March 5, 2020 Category: Medical Law Source Type: research
2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee
ConclusionThis guideline provides direction for clinicians and patients making treatment decisions for the management of OA. Clinicians and patients should engage in shared decision ‐making that accounts for patients’ values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies. (Source: Arthritis and Rheumatology)
Source: Arthritis and Rheumatology - January 5, 2020 Category: Rheumatology Authors: Sharon L. Kolasinski,
Tuhina Neogi,
Marc C. Hochberg,
Carol Oatis,
Gordon Guyatt,
Joel Block,
Leigh Callahan,
Cindy Copenhaver,
Carole Dodge,
David Felson,
Kathleen Gellar,
William F. Harvey,
Gillian Hawker,
Edward Herzig,
C. Kent Kwoh,
Ama Tags: Original Article Source Type: research
Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial
Conclusions:
Preoperative fascia iliaca compartment block significantly decreases postoperative opioid consumption while improving patient satisfaction. We recommend the integration of this safe and efficacious modality into institutional geriatric hip fracture protocols as an adjunctive pain control strategy.
Level of Evidence:
Therapeutic Level II See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - December 19, 2019 Category: Orthopaedics Tags: Original Article Source Type: research
Dental pain management with prescription opioids by nondental health care professionals in a health care system network
ConclusionsDental-related pain is often managed by nondental health care professionals in an ED or urgent care setting. An EHR alert may help quickly identify high-risk patients; however, the impact of alerts on prescribing patterns needs further evaluation. The decision regarding the type and quantity of medication to prescribe is complicated by lack of patient access to definitive dental treatment and lack of dental-specific training of prescribers. The limitations of this study include selective inclusion of encounters with specific ICD-9/ICD-10 codes, data limited to objectively searchable criteria, data collection for...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - December 15, 2019 Category: ENT & OMF Source Type: research
Response to Propoxyphene Market Withdrawal: Analgesic Substitutes, Doses, and Adverse Events
Conclusions:
After propoxyphene market withdrawal, many individuals experienced abrupt discontinuation of opioids. Policymakers might consider supporting appropriate treatment transitions and monitoring responses following drug withdrawals. (Source: Medical Care)
Source: Medical Care - December 12, 2019 Category: Health Management Tags: Original Article Source Type: research
Pharmacological strategies in multimodal analgesia for adults scheduled for ambulatory surgery
Purpose of review
The present review aims to propose pharmacological strategies to enhance current clinical practices for analgesia in ambulatory surgical settings and in the context of the opioid epidemic.
Recent findings
Each year, a high volume of patients undergoes ambulatory surgery worldwide. The multimodal analgesia proposed to ambulatory patients must provide the best analgesic effect and patient satisfaction while respecting the rules of safety for ambulatory surgery. The role of nurses, anesthesiologists, and surgeons around said surgery is to relieve suffering, achieve early mobilization and patient satisfa...
Source: Current Opinion in Anaesthesiology - November 5, 2019 Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research
