Editor's Note Postoperative pain trajectories can identify patients at risk for 30-day readmissions and emergency department (ED) visits, and are not mediated by postdischarge complications, this study finds. In this analysis of 211,231 surgical procedures (45.4% orthopedic, 37.0% general, and 17.6% vascular), the 30-day unplanned readmission rate was 10.8%, and…

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Editor's Note In this meta-analysis of the effectiveness of nonpharmacological interventions for pain after total knee arthroplasty, electrotherapy and acupuncture were associated with reduced and delayed opioid consumption, but there was low or very low certainty that they improved pain. Continuous passive motion and preoperative exercise did not improve pain…

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Editor's Note The initial event associated with exposure to prescription opioids is often thought to be an injury or surgical procedure, but this study finds that opioid use rarely starts with surgical procedures. Of 117,118 patients with sustained prescription opioid use who were analyzed, just 800 (0.7%) received their initial…

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Editor's Note Emergency department (ED) visits after total joint procedures were numerous and mostly for pain-related diagnoses, and Medicaid patients had almost double the risk of an ED or pain-related ED visit, this study finds. Of 152,783 patients analyzed, 3.42% returned to the inpatient setting and 5.81% visited the ED…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note The Accreditation Association for Ambulatory Health Care (AAAHC) on May 8 announced the release of its new Opioid Stewardship Toolkit to help providers review and assess the volume and length of opioid prescriptions and dosages to mitigate risk of patient overdose and death. AAAHC created the toolkit to…

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Editor's Note The combination of femoral and sciatic nerve blocks is the overall best approach to pain management after total knee arthroplasty, finds this meta-analysis. The best five modalities for pain at rest were: femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks. For reducing opioid consumption, the best…

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Editor's Note New persistent postoperative opioid use is common and does not differ between minor and major procedures, but, instead, it is associated with behavioral and pain disorders, this study finds. Of 36,177 elective surgery patients assessed, about 6% filled opioid drug prescriptions between 90 and 180 days after the…

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Editor's Note In this study, music therapy was found to decrease pain in patients recovering from spine surgery, compared to a control group who received standard care. Visual analog scale (VAS) pain levels before and after music therapy decreased by more than one point, from 6.20 to 5.09, while VAS…

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Editor's Note Opioid use before major abdominal surgery was independently associated with increased postoperative healthcare utilization and morbidity in this study. Of 2,413 patients analyzed, 502 used opioids preoperatively. After covariate adjustment, opioid users, compared with non-opioid users had: higher costs ($26,604 vs $24,263) longer lengths of stay (5.9 vs…

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