Post-Surgical Pain

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Predicting Acute Pain After Cesarean Delivery to Reduce Risk for Persistent Pain

Predicting Acute Pain After Cesarean Delivery to Reduce Risk for Persistent Pain

The most promising tools to predict acute pain after cesarean delivery are local anesthetic infiltration before placement of spinal anesthesia, and asking patients simple questions about anticipated pain and analgesic needs.

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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

Prediction Model Shows Accuracy in Estimating Outcomes After Low Back Surgery

Prediction Model Shows Accuracy in Estimating Outcomes After Low Back Surgery

A multivariable prediction model for outcome after lower back surgery may reliably predict 12-month improvements.

Conventional vs High-Frequency Spinal Cord Stimulation for Chronic Pain

Conventional vs High-Frequency Spinal Cord Stimulation for Chronic Pain

In a preliminary study, high-frequency spinal cord stimulation was found to be more effective in treating chronic pain than conventional stimulation.

Reducing Opioid Consumption After Scoliosis Surgery in Adolescents

Reducing Opioid Consumption After Scoliosis Surgery in Adolescents

Intravenous acetaminophen with or without ketorolac is associated with reduced opioid consumption and cost of care after scoliosis surgery in adolescents.

Clinical Pain Assessment Tools May Not Be Useful in Sedated Patients in the ICU

Clinical Pain Assessment Tools May Not Be Useful in Sedated Patients in the ICU

The Critical-Care Pain Observation Tool and the Behavioral Pain Scale may not be optimal tools to assess pain levels in agitated or sedated patients in intensive care units.

Reverse Total Shoulder Arthroplasty: Long-Term Clinical, Subjective Outcomes

Reverse Total Shoulder Arthroplasty: Long-Term Clinical, Subjective Outcomes

Reverse total shoulder arthroplasty in patients with irreparable rotator cuff tear may lead to long-term improvements in range of motion and pain levels, but may be associated with high rates of complications.

No Added Benefit for Acupuncture in Routine Rehabilitation After Total Knee Replacement

No Added Benefit for Acupuncture in Routine Rehabilitation After Total Knee Replacement

The addition of adjunctive acupuncture to routine rehabilitation therapy after total knee replacement may not provide a significant benefit over exercise only for relieving postoperative pain.

Handover of Intraoperative Anesthesia Care Linked to Increase in Adverse Postoperative Outcomes

Handover of Intraoperative Anesthesia Care Linked to Increase in Adverse Postoperative Outcomes

Complete handover of intraoperative anesthesia care is associated with an increased risk of adverse postoperative outcomes among adults undergoing major surgery.

Perioperative Gabapentin May Modestly Promote Postoperative Opioid Cessation

Perioperative Gabapentin May Modestly Promote Postoperative Opioid Cessation

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.

Intravenous Acetaminophen May Reduce Hospital Length of Stay in Adolescents Undergoing Posterior Spinal Fusion

Intravenous Acetaminophen May Reduce Hospital Length of Stay in Adolescents Undergoing Posterior Spinal Fusion

Postoperative management of adolescents undergoing posterior spinal fusion surgery with intravenous acetaminophen may have an opioid-sparing effect, due to a reduced hospital length of stay.

Statins Ineffective in Reducing Pain, Opioid Consumption After Hip Surgery

Statins Ineffective in Reducing Pain, Opioid Consumption After Hip Surgery

The use of statins after hip surgery may not reduce pain levels or the need for opioids.

Chronic Postoperative Pain Risk Linked to Gene Polymorphisms

Chronic Postoperative Pain Risk Linked to Gene Polymorphisms

Genetics may be a factor in the experience of chronic postoperative pain as 42 polymorphisms were found to be correlated with chronic postsurgical pain.

Preoperative Cholesterol Levels Not Linked With Laparoscopic Postoperative Pain

Preoperative Cholesterol Levels Not Linked With Laparoscopic Postoperative Pain

Preoperative levels of serum total cholesterol do not correlate with postoperative pain following laparoscopic surgery for gastric cancer.

Opioid Prescribing vs Consumption Following Rhinoplasty

Opioid Prescribing vs Consumption Following Rhinoplasty

Patients used only 40% of the hydrocodone-acetaminophen combination tablets prescribed to them following rhinoplasty.

Postoperative Pain Management in Children With Developmental Delay

Postoperative Pain Management in Children With Developmental Delay

Parent- and nurse-controlled analgesia may not reduce postoperative pain in children with developmental delay compared with opioids administered by a nurse as needed.

Smoking Cessation May Increase Postoperative Opioid Use

Smoking Cessation May Increase Postoperative Opioid Use

Abstinent smokers may have reduced preoperative pain tolerance and increased postoperative opioid use compared with nonsmokers.

Fast Track Designation Granted for Post-Surgical Pain Medication

Fast Track Designation Granted for Post-Surgical Pain Medication

The FDA has granted Fast Track Designation to the investigational treatment CA-008 (Concentric Analgesics) for the treatment of post-surgical pain.

Lower Surgical Pleth Index Target Provides Better Estimate of Pediatric Postsurgical Pain

Lower Surgical Pleth Index Target Provides Better Estimate of Pediatric Postsurgical Pain

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.

Opioid Prescribing Suboptimal in Setting of Enhanced Recovery After Surgery

Opioid Prescribing Suboptimal in Setting of Enhanced Recovery After Surgery

Implementation of an enhanced recovery after surgery protocol resulted in an increase in opioid-free anesthesia and multimodal analgesia, but did not modify opioid prescribing practices.

New Drug Application Submitted for Olinvo to Treat Acute Pain

New Drug Application Submitted for Olinvo to Treat Acute Pain

Trevena has submitted their New Drug Application to the FDA for Olinvo, an oliceridine injection, for the management of moderate-to-severe pain in the hospital and similar settings.

Intraoperative Naloxone Reduces Remafentanil-Induced Postoperative Hyperalgesia

Intraoperative Naloxone Reduces Remafentanil-Induced Postoperative Hyperalgesia

Intraoperative low-dose naloxone reduced postoperative hyperalgesia but had no effect on pain when combined with high-dose remifentanil for elective thyroid surgery.

Midazolam Plus Morphine: Continuous vs Intermittent Infusions for Pediatric Postsurgical Pain

Midazolam Plus Morphine: Continuous vs Intermittent Infusions for Pediatric Postsurgical Pain

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.

Intraoperative Esmolol Decreases Intraoperative, Postoperative Opioid Use

Intraoperative Esmolol Decreases Intraoperative, Postoperative Opioid Use

Esmolol was shown to reduce the use of opioids during and after surgery without having a significant impact on postoperative pain scores.

Ibuprofen Comparable With Morphine for Postoperative Pain in Children

Ibuprofen Comparable With Morphine for Postoperative Pain in Children

Among children who have undergone minor outpatient orthopedic surgery, ibuprofen provides equivalent postoperative pain relief compared with oral morphine.