Pain

Latest Issue of OR Manager
August 2019

Statewide initiative reduces postop opioid prescribing without increase in patient pain

Editor's Note Implementation of opioid prescribing guidelines in the state of Michigan reduced opioid prescription size without negatively affecting patient satisfaction or pain, this study finds. In 1 year, teams at 43 hospitals across the state reduced by nearly one-third the number of opioid pills they prescribed to patients (having…

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By: Judy Mathias
August 15, 2019
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Patient factors tied to postop opioid consumption

Editor's Note In this study of opioid-naïve patients having major surgery, researchers found a number of patient characteristics associated with greater opioid use in the first month after surgery. Of 1,181 patients analyzed, the following were significantly associated with increased postoperative opioid consumption: younger age nonwhite race lack of college…

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By: Judy Mathias
August 7, 2019
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Preop opioid score not linked to adverse outcomes after spine surgery

Editor's Note NarxCare, an opioid-use score based on state prescription databases, is not associated with adverse outcomes or patient satisfaction after elective spine surgery, this study finds. Multivariate logistic regression analysis of 346 elective spine surgery patients did not find statistically significant odds of experiencing adverse events, readmissions, reoperations, and…

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By: Judy Mathias
July 31, 2019
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Tackling the opioid crisis through community teamwork

The opioid epidemic has risen to alarming proportions in the United States, claiming 46,000 lives in 2018. Studies and federal reports documenting evidence of narcotics overuse and addiction in patients have built momentum to curb prescribing habits. Responding to these trends, a Midwestern orthopedic practice launched a multiphase project to…

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By: Jennifer Lubell
July 24, 2019
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Music reduces anxiety before regional anesthesia

Editor's Note Music is a viable alternative to IV midazolam in reducing anxiety before a preoperative peripheral nerve block, this study finds. A total of 157 adult patients were randomly assigned to one of two options 3 minutes before peripheral nerve block−either an injection of 1-2 mg of midazolam or…

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By: Judy Mathias
July 23, 2019
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CDC: Drug overdose mortality drops for the first time in 20 years

Editor's Note The US drug overdose mortality rate dropped 5.1% to 68,557 deaths last year, compared with 72,224 in 2017, the Centers for Disease Control & Prevention (CDC) reported on July 17. It’s the first time overdose mortality has declined since 1999. The CDC noted that the death counts are…

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By: Judy Mathias
July 18, 2019
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Sleep disorders linked to more healthcare visits, higher costs for back pain

Editor's Note Many patients with low back pain also have sleep disorders, which are linked to more healthcare visits and higher costs for back pain treatment, this study finds. In this analysis of 757 patients with low back pain attending self-management classes at a US military hospital, 195 had a…

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By: Judy Mathias
July 10, 2019
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Effect of fewer postop opioids prescribed, preop education on opioid consumption

Editor's Note Prescribing fewer opioid tablets postoperatively was associated with lower opioid consumption after anterior cruciate ligament reconstruction, and preoperative education was associated with lower duration and quantity of postoperative opioid use, this study finds. Of 264 patients analyzed, 109 received 50 tablets, 77 received 30 tablets and no education,…

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By: Judy Mathias
June 25, 2019
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Opioid epidemic increases number of hearts available for transplant

Editor's Note The opioid epidemic has expanded the pool of overdose-death donors (ODDs) for heart transplantation. Even though ODDs have higher rates of hepatitis C, cardiac allograft quality indices are favorable, and recipient outcomes are similar to those with non-ODD hearts, this study finds. Of 15,904 heart transplant donors analyzed,…

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By: Judy Mathias
June 6, 2019
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Opiate-sparing analgesia after discharge from total hip

Editor's Note Multimodal analgesia with minimal opiates improved pain control and significantly decreased opiate use and opiate-related adverse effects after discharge from elective total hip replacement surgery, finds this study. The 235 patients analyzed received one of three discharge pain regimens: Group A: scheduled-dose multimodal analgesia (ie, acetaminophen, meloxicam, gabapentin)…

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By: Judy Mathias
June 6, 2019
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