Post-Surgical Pain

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Optimal Strategies for Opioid Weaning After Ambulatory Surgery

Optimal Strategies for Opioid Weaning After Ambulatory Surgery

Although there is a scarcity of evidence pertaining to the management of postoperative pain medication in the ambulatory setting, some findings suggest an approach similar to that used for the treatment of acute pain.

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Wide Variations in Opioid Prescribing Practices for Surgical Procedures

Wide Variations in Opioid Prescribing Practices for Surgical Procedures

Variation exists in opioid prescribing practices among clinicians in single-hospital systems, which prompts concern about the potential for opioid overprescribing.

Women Frequently Prescribed High Doses of Opioids After Vaginal Delivery

Women Frequently Prescribed High Doses of Opioids After Vaginal Delivery

Women who undergo vaginal delivery in the United States may frequently be prescribed opioid medications for pain within 1 week of hospital discharge, often dispensed at high doses and in significant quantities.

Preoperative Opioid Use Highly Prevalent, Associated With Age, Tobacco Use

Preoperative Opioid Use Highly Prevalent, Associated With Age, Tobacco Use

Preoperative opioid use was reported by approximately 23% of patients undergoing surgery, with age, tobacco use, depression, poor life satisfaction, and medical comorbidities identified as independent factors associated with pre-interventional opioid use.

Postpartum Pain Management Recommendations From the American College of Obstetricians and Gynecologists

Postpartum Pain Management Recommendations From the American College of Obstetricians and Gynecologists

A committee from the American College of Obstetricians and Gynecologists formulated several recommendations for safely managing pain and fatigue in women during the early postpartum period.

Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKR

Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKR

Individuals with knee osteoarthritis who have indicators of high vs low/no levels of neuropathic pain may be at elevated risk for chronic pain after total knee replacement surgery.

Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding

Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding

Labor epidural analgesia may be associated with reduced likelihood of breastfeeding at 6 weeks.

Post-Op Pain Treatment Gets Breakthrough Therapy Designation

Post-Op Pain Treatment Gets Breakthrough Therapy Designation

The Company indicated that they will work towards an New Drug Application submission for the treatment in the second half of 2018.

Opioid-Related Adverse Events Common After Invasive Procedures

Opioid-Related Adverse Events Common After Invasive Procedures

For patients undergoing invasive procedures, opioid-related adverse drug events are common and are associated with worse clinical and cost outcomes.

Opioid-Free Analgesia Use for Postsurgical Pain Limited

Opioid-Free Analgesia Use for Postsurgical Pain Limited

The use of opioid-free analgesia to manage postsurgical pain is still limited, particularly in some patient groups that may be at a higher risk for opioid-related adverse drug events.

Clonidine May Not Improve Post-Cesarean Delivery Analgesia

Clonidine May Not Improve Post-Cesarean Delivery Analgesia

Administration of clonidine — intrathecally or intravenously — may not supplement spinal anesthesia-associated analgesia after cesarean delivery.

Factors ID'd for Persistent Opioid Use After Pediatric Surgery

Factors ID'd for Persistent Opioid Use After Pediatric Surgery

With the distinct qualities that come from post-surgical procedures in the realm of pediatrics, conclusions are still being considered.

Benefit of Liposomal Bupivacaine for Pain in TKA Questioned

Benefit of Liposomal Bupivacaine for Pain in TKA Questioned

Liposomal bupivacaine use in patients undergoing total knee arthroplasty is not associated with clinically meaningful reductions in inpatient opioid use, resource utilization, or opioid-related complications.

Perioperative Lidocaine May Reduce Risk for Chronic Postsurgical Pain

Perioperative Lidocaine May Reduce Risk for Chronic Postsurgical Pain

Perioperative lidocaine infusions may reduce the likelihood of developing chronic postsurgical pain.

Anesthetic-Loaded Bone Cements May Accelerate Post-Reconstruction Recovery

Anesthetic-Loaded Bone Cements May Accelerate Post-Reconstruction Recovery

Calcium phosphate cement loaded with bupivacaine vs ropivacaine may accelerate functional recovery after bone reconstruction surgery and maintain bone-filling properties.

Regional Anesthesia Tied to Lower Opioid Use in TKA, THA

Regional Anesthesia Tied to Lower Opioid Use in TKA, THA

Regional anesthesia is associated with a lower opioid consumption in both knee and hip replacement surgeries, compared to general anesthesia.

Efficacy of IV Meloxicam for Bunionectomy-Associated Pain

Efficacy of IV Meloxicam for Bunionectomy-Associated Pain

A once-daily intravenous injection of meloxicam may safely and effectively relieve moderate to severe bunionectomy-associated pain.

Opioid-Related Adverse Drug Events Associated With Worse Patient, Cost Outcomes

Opioid-Related Adverse Drug Events Associated With Worse Patient, Cost Outcomes

Adverse events associated with opioids administered for the management of postsurgical and postendoscopy pain may be associated with worse cost and patient outcomes.

IV Tramadol Significantly Reduces Post-Op Pain in Phase 3 Study

IV Tramadol Significantly Reduces Post-Op Pain in Phase 3 Study

In this multicenter, double-blind, placebo-controlled trial, patients (N=409) were randomized 1:1:1 to a postoperative regimen of IV tramadol 50mg, IV tramadol 25mg, or placebo administered over 15 minutes at hours 0, 2, 4, and once every 4 hours thereafter (up to 13 doses).

Patient-Controlled Analgesia Pumps Have Low Device-Related Error Rates

Patient-Controlled Analgesia Pumps Have Low Device-Related Error Rates

The management of postsurgical pain with patient-controlled analgesia pumps may be safe, as indicated by a low rate of device-related error.

Opioids Often Over-Prescribed After Hiatal Hernia Surgery

Opioids Often Over-Prescribed After Hiatal Hernia Surgery

The researchers found that the median prescription size was 350 mg oral morphine equivalents and median patient use was 225 mg oral morphine equivalents following open hiatal hernia repair.

Evaluating Analgesic Benefits of NSAID Combinations for Acute Postoperative Dental Pain

Evaluating Analgesic Benefits of NSAID Combinations for Acute Postoperative Dental Pain

Acetaminophen in combination with ibuprofen or oxycodone, as well as diclofenac, and flurbiprofen may offer more effective analgesia for acute postoperative dental pain in adults.

Opioid Use After Elective Surgery Quantified

Opioid Use After Elective Surgery Quantified

Researchers conducted a prospective survey of patients to investigate postoperative opioid use.

Eight Factors Predict Pain After Spine Surgery

Eight Factors Predict Pain After Spine Surgery

An elastic net algorithm was used to create a predictive model of postoperative pain in the first 24 hours after surgery using a randomly selected training cohort.

Opioids, Sedatives, and the Risk for Cardiopulmonary and Respiratory Arrest

Opioids, Sedatives, and the Risk for Cardiopulmonary and Respiratory Arrest

Opioids and sedatives may represent independent and additive predictors of cardiopulmonary and respiratory arrest in both medical and surgical patients.

Intraoperative Opioid Doses and Rates of Hospital Readmission

Intraoperative Opioid Doses and Rates of Hospital Readmission

The use of high doses of opioids — particularly long-acting opioids — during surgery may increase the risk for 30-day readmission.

Mechanical Plus Chemical Adhesiolysis During Epiduroscopy After Failed Spine Surgery

Mechanical Plus Chemical Adhesiolysis During Epiduroscopy After Failed Spine Surgery

Administration of hyaluronidase and corticosteroid methylprednisolone acetate to the epidural space during epiduroscopy for failed back surgery-related radicular pain may improve back pain and disability at 1 year.

Widespread Impact of Reducing Opioids, Adding IV Acetaminophen for Postsurgical Pain Management

Widespread Impact of Reducing Opioids, Adding IV Acetaminophen for Postsurgical Pain Management

Postoperative pain management that combines a reduction of opioids with the use of intravenous acetaminophen may shorten hospital length of stay, reduce the rate of complications related to opioids, and lower related costs.

Exparel Approved for Use as Interscalene Brachial Plexus Nerve Block

Exparel Approved for Use as Interscalene Brachial Plexus Nerve Block

Additionally, statistical significance vs placebo was also achieved in total postsurgical opioid consumption through 48 hours (P<0.0001); opioid-free subjects through 48 hours (P<0.01); and time to first opioid rescue through 48 hours (P<0.0001).

Multimodal Analgesia After Knee, Hip Arthroplasty and Perioperative Outcomes

Multimodal Analgesia After Knee, Hip Arthroplasty and Perioperative Outcomes

Multimodal analgesia after hip or knee arthroplasty may be associated with fewer complications and reduced opioid prescriptions and hospital length of stay, compared with unimodal analgesia.

Multimodal Analgesia Cuts Complications Post Arthroplasty

Multimodal Analgesia Cuts Complications Post Arthroplasty

Fewer respiratory, GI issues; reductions also seen in opioid prescriptions and hospital length of stay