Pain

Latest Issue of OR Manager
August 2018

CDC: Naloxone use by emergency medical services up 75% in 4 years

Editor's Note Naloxone administration by emergency medical services increased 75.1% between 2012 and 2016, mirroring a 79.7% increase in fatal opioid overdoes during the same time period, according to the August 10 Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC). Young adults made…

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By: Judy Mathias
August 13, 2018
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Spillover effect of postop opioid prescribing

Editor's Note After opioid prescribing recommendations were implemented for a single surgical procedure, laparoscopic gall bladder removal, opioid prescribing decreased for four other surgical procedures in this study. The analysis involved 1,158 patients, 558 who had surgery before the opioid recommendations were implemented and 600 after implementation. Opioid prescription size…

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By: Judy Mathias
July 30, 2018
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Opioid use before total joint replacements linked to higher readmission, revision rates

Editor's Note Preoperative opioid use was associated with significantly increased risks of early revisions and 30-day readmissions after total knee and total hip arthroplasties, this study finds. The study included 324,154 patients in a 1-year follow-up group and 159,822 in a 3-year follow-up group. For total knee patients, the hospital…

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By: Judy Mathias
July 19, 2018
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Lowering default pill counts in EHR systems associated with postop opioid prescribing

Editor's Note Lowering the default number of opioid pills prescribed in an electronic health record (EHR) system is a simple, effective, inexpensive, and potentially scalable intervention to change prescriber behavior and decrease the amount of opioids prescribed postoperatively, finds this study. In this analysis of 1,447 procedures before the default…

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By: Judy Mathias
July 19, 2018
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Study: Prevalence of preop opioid use and patient characteristics

Editor's Note In this study of 34,186 surgical patients in the University of Michigan Health System, 23.1% were taking opioids preoperatively, and the use of opioids was associated with a more negative medical and pain profile. Patient age, tobacco use, illicit drug use, higher pain severity, depression, higher Fibromyalgia Survey…

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By: Judy Mathias
July 12, 2018
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FDA statement on access to opioids for patients with chronic, end-of-life pain

Editor's Note Food & Drug Administration (FDA) commissioner, Scott Gottlieb, MD, on July 9 issued a statement on balancing access to appropriate treatment for patients with chronic and end-of-life pain with the need to stem the misuse and abuse of opioids. As the FDA considers new steps to address the…

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By: Judy Mathias
July 12, 2018
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Prevalence of unused opioids after joint, spine surgery

Editor's Note In this study, many patients reported unused opioids after joint and spine surgery, infrequent use of nonopioid analgesics, and lack of knowledge on safe opioid storage and disposal. Of 140 patients analyzed, 35% were taking preoperative opioids. Among those who stopped taking opioids after surgery, possession of unused…

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By: Judy Mathias
June 27, 2018
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Factors predicting postop opioid used in spine surgery patients

Editor's Note Patients having surgery for degenerative spondylolisthesis (DS) are less likely to be dependent on opioids after surgery than before, this study finds. Of 10,708 DS patients who had surgery between 2000 and 2012, 14.85% were opioid dependent within 12 months before surgery, and 9.90% were opioid dependent 3…

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By: Judy Mathias
June 27, 2018
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Joint Commission releases prepublication revisions for pain assessment and management standards

Editor's Note The Joint Commission on June 25 released new and revised pain assessment and management standards that will be applicable to accredited critical access hospitals and ambulatory care and office-based surgery organizations, effective January 1, 2019. The standards are designed to strengthen an organization’s practices for pain assessment, treatment,…

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By: Judy Mathias
June 27, 2018
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New formulation of bupivacaine does not reduce opioid use after TKA

Editor's Note Contrary to what some studies are suggesting, use of the local anesthetic liposomal bupivacaine as part of a multimodal approach to postoperative pain did not reduce in-hospital opioid use or opioid-related complications after total knee arthroplasty (TKA) in this study. Researchers analyzed data on 88,830 TKAs performed with…

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By: Judy Mathias
May 21, 2018
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