Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKRJuly 20, 2018
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.
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.
Psychosocial interventions such as patient education and relaxation techniques may help reduce pain after orthopedic surgery and improve quality of clinical care.
Perioperative lidocaine delivered intravenously may not improve pain, gastrointestinal recovery, postoperative nausea, or opioid consumption in the early postoperative phase compared with placebo or no treatment.
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.
With the distinct qualities that come from post-surgical procedures in the realm of pediatrics, conclusions are still being considered.
With the increasing number of patients presenting to surgery with opioid tolerance, clinicians should be familiar with their specific analgesic needs.
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.
Calcium phosphate cement loaded with bupivacaine vs ropivacaine may accelerate functional recovery after bone reconstruction surgery and maintain bone-filling properties.
Regional anesthesia is associated with a lower opioid consumption in both knee and hip replacement surgeries, compared to general anesthesia.
A once-daily intravenous injection of meloxicam may safely and effectively relieve moderate to severe bunionectomy-associated pain.
Adverse events associated with opioids administered for the management of postsurgical and postendoscopy pain may be associated with worse cost and patient outcomes.
Suspecting that this phenomenon might be the source of my nighttime pain, causing significant REM sleep deprivation, I reasoned that a neuromodulator such as a gabapentinoid might be helpful.
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.
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.
Opioids and sedatives may represent independent and additive predictors of cardiopulmonary and respiratory arrest in both medical and surgical patients.
The use of high doses of opioids — particularly long-acting opioids — during surgery may increase the risk for 30-day readmission.
A multivariable prediction model for outcome after lower back surgery may reliably predict 12-month improvements.
Systemic lidocaine administered via IV or patch has consistently shown effectiveness for the treatment and prevention of chronic pain.
Prescription opioid duration — not dosage — following surgery may be associated with a greater risk for opioid misuse in patients with no prior history of opioid use.
Disseminating an educational brochure improves disposal of unused opioids after surgery.
Opioids may be overprescribed frequently after surgery in most specialties.
Compared with placebo, gabapentin administered pre- and postoperatively may reduce the time to postoperative opioid cessation, but was not shown to improve postoperative pain resolution.
The use of statins after hip surgery may not reduce pain levels or the need for opioids.
Genetics may be a factor in the experience of chronic postoperative pain as 42 polymorphisms were found to be correlated with chronic postsurgical pain.
Patients used only 40% of the hydrocodone-acetaminophen combination tablets prescribed to them following rhinoplasty.
A Surgical Pleth Index target level lower than that reported in the current literature may be more appropriate in research studies examining SPI-guided anesthesia in pediatric patients.
Intraoperative low-dose naloxone reduced postoperative hyperalgesia but had no effect on pain when combined with high-dose remifentanil for elective thyroid surgery.
Fewer randomized controlled trials include children vs adult cohorts, and the evidence pertaining to this population.
Continuous infusions of midazolam plus morphine do not provide additional pain relief compared with intermittent dosing of those drugs, and may increase hospital length of stay among pediatric patients who have undergone cardiac surgery.
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