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Opioid Prescribing Habits of Emergency Department Providers in Response to an Educational Intervention
CONCLUSION: Overall, the educational intervention on the topic of opioid prescribing guidelines did not have the expected impact on amounts of opioids administered or prescribed during the study period. Total opioids utilized and opioids prescribed did not vary between the pre- and post-intervention groups overall, by subset diagnosis, or by provider. There was, however, an increase in utilization of non-opioid treatments that could be indicative of a partial response to the educational intervention. This study showed that long-term effects of education regarding recommended opioid utilization might be less effective than ...
Source: Pain Physician - September 22, 2023 Category: Anesthesiology Authors: Tory Makela Source Type: research

Patient Controlled Subcutaneous Analgesia of Hydromorphone Versus Morphine to Treat Moderate and Severe Cancer Pain: A Randomized Double-Blind Controlled Trial
Hydromorphone and morphine are the common drugs used for the treatment of moderate to severe cancer pain. Patient controlled subcutaneous analgesia (PCSA) is an effective technique to manage cancer pain. However, few studies have been conducted to show the efficacy and safety of PCSA of hydromorphone for the relief of cancer pain.
Source: Journal of Pain and Symptom Management - September 22, 2023 Category: Palliative Care Authors: Xianzheng Zeng, Jiang Zhu, Jun Li, Chan Chen, Ling Sang, Maotong Liu, Li Song, Hui Liu Tags: Original Article Source Type: research

Discharge prescribing and subsequent opioid use after traumatic musculoskeletal injury
CONCLUSIONS: After surgery for musculoskeletal injury, patients discharged by residents who prescribe greater supplies of opioid pain medications received higher supplies of opioids 7 to 8 months after surgery than patients discharged by residents who tend to prescribe less. Thus, limiting postoperative supplies of opioid pain medication may help reduce chronic opioid use.PMID:37729527 | DOI:10.37765/ajmc.2023.89424
Source: Pain Physician - September 20, 2023 Category: Anesthesiology Authors: Matthew F Basilico Abhiram R Bhashyam Emma K Harrington Monica Bharel J Michael McWilliams Marilyn Heng Source Type: research

Effect of transversus abdominis plane block on postoperative outcomes in gynecologic oncology patients managed on an Enhanced Recovery After Surgery pathway
CONCLUSIONS: Surgeon-administered TAP blocks were associated with decreased length of stay and post-operative opioid use in patients not receiving scheduled NSAIDs. This decrease in opioid use was not associated with any increase in average or maximum pain scores.PMID:37729808 | DOI:10.1016/j.ygyno.2023.09.003
Source: Gynecologic Oncology - September 20, 2023 Category: Cancer & Oncology Authors: Kristin A Black Gregg Nelson Natalie Goucher Joshua Foley Sophia Pin Michael Chong Sunita Ghosh Steven P Bisch Source Type: research

Discharge prescribing and subsequent opioid use after traumatic musculoskeletal injury
CONCLUSIONS: After surgery for musculoskeletal injury, patients discharged by residents who prescribe greater supplies of opioid pain medications received higher supplies of opioids 7 to 8 months after surgery than patients discharged by residents who tend to prescribe less. Thus, limiting postoperative supplies of opioid pain medication may help reduce chronic opioid use.PMID:37729527 | DOI:10.37765/ajmc.2023.89424
Source: The American Journal of Managed Care - September 20, 2023 Category: Health Management Authors: Matthew F Basilico Abhiram R Bhashyam Emma K Harrington Monica Bharel J Michael McWilliams Marilyn Heng Source Type: research

Consistently low creatinine on UDS??
I have a patient who was referred by a retiring rheumatologist on 90 MMES morphine. She was consistently short on her morphine and I transitioned to buprenorphine. Since starting buprenorphine every UDS (three times now) has reported abnormal creatinine (“dilute urine. May result in false negative. Possible deliberate diluation.”) Her UDS on her initial visit did not show abnormal creatinine. Could there a physiological reason for this or is she being facitious? I felt I couldn’t definitely... Read more
Source: Student Doctor Network - September 20, 2023 Category: Universities & Medical Training Authors: PainBrain78 Tags: Pain Medicine Source Type: forums

The effect of morphine on rat microglial phagocytic activity: An in vitro study of brain region-, plating density-, sex-, morphine concentration-, and receptor-dependency
Opioids have long been used for clinical pain management, but also have addictive properties that have contributed to the ongoing opioid epidemic. While opioid activation of opioid receptors is well known to contribute to reward and reinforcement, data now also suggest that opioid activation of immune signaling via toll-like receptor 4 (TLR4) may also play a role in addiction-like processes. TLR4 expression is enriched in immune cells, and in the nervous system is primarily expressed in microglia.
Source: Journal of Neuroimmunology - September 20, 2023 Category: Allergy & Immunology Authors: David N. King'uyu, Lily Nti-Kyemereh, Jesse L. Bonin, Paul J. Feustel, Michelle Tram, Katherine C. MacNamara, Ashley M. Kopec Source Type: research

Multimodal Analgesia in Pediatric Cancer Pain Management: A Retrospective Single-Center Study
Conclusions The pain level that pediatric cancer patients endure critically influences their and their family's quality of life. The fact that opioid-related adverse effects associated with pediatric pain management occur far less frequently than previously thought may help prevent opiophobia. Effective and safe analgesia can be provided with multimodal analgesia to manage pediatric cancer pain.PMID:37720121 | PMC:PMC10501176 | DOI:10.7759/cureus.45223
Source: Cancer Control - September 18, 2023 Category: Cancer & Oncology Authors: Mesut Bak ır Şebnem Rumeli Argun Pire Source Type: research

Opioid-Sparing Effect of Intrathecal Morphine for Postoperative Pain Control
Anesth Analg. 2023 Oct 1;137(4):e34. doi: 10.1213/ANE.0000000000006535. Epub 2023 Sep 5.NO ABSTRACTPMID:37712477 | DOI:10.1213/ANE.0000000000006535
Source: Anesthesia and Analgesia - September 15, 2023 Category: Anesthesiology Authors: Fu-Shan Xue Xin-Tao Li Tian Tian Source Type: research