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.
Labor epidural analgesia may be associated with reduced likelihood of breastfeeding at 6 weeks.
The Company indicated that they will work towards an New Drug Application submission for the treatment in the second half of 2018.
For patients undergoing invasive procedures, opioid-related adverse drug events are common and are associated with worse clinical and cost outcomes.
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.
Administration of clonidine — intrathecally or intravenously — may not supplement spinal anesthesia-associated analgesia after cesarean delivery.
With the distinct qualities that come from post-surgical procedures in the realm of pediatrics, conclusions are still being considered.
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 infusions may reduce the likelihood of developing chronic postsurgical pain.
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.
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).
The management of postsurgical pain with patient-controlled analgesia pumps may be safe, as indicated by a low rate of device-related error.
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.
Researchers conducted a prospective survey of patients to investigate postoperative opioid use.
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 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.
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.
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.
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 hip or knee arthroplasty may be associated with fewer complications and reduced opioid prescriptions and hospital length of stay, compared with unimodal analgesia.
Fewer respiratory, GI issues; reductions also seen in opioid prescriptions and hospital length of stay
A multivariable prediction model for outcome after lower back surgery may reliably predict 12-month improvements.
In a preliminary study, high-frequency spinal cord stimulation was found to be more effective in treating chronic pain than conventional stimulation.
Intravenous acetaminophen with or without ketorolac is associated with reduced opioid consumption and cost of care after scoliosis surgery in adolescents.
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 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.
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