Postoperative Pain and Opioid Dose Requirements in Patients on Sublingual Buprenorphine

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ryu Komatsu ◽  
Michael Nash ◽  
Katherin A. Peperzak ◽  
Jiang Wu ◽  
Emily M. Dinges ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Opioid Dose ◽  
Sublingual Buprenorphine

scholarly journals The Effect of Preoperative Opioid Dosage on Postoperative Outcomes in Patients Undergoing Knee Surgery

2020 ◽  
Vol 1;23 (1;1) ◽  
pp. 73-85
Author(s):  
Bohan Xing
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Pain Control ◽  
Dose Group ◽  
Low Dose ◽  
Knee Surgery ◽  
High Dose ◽  
Postoperative Pain Control ◽  
Opioid Dose ◽  
Ed Visits

Background: Opioid prescription before knee replacement surgery is associated with longer hospital stays, more postsurgical pain, and a higher rate of complications. Despite the growing evidence against opioids, they remain popular preoperative pain management prescriptions. Objectives: The purpose of this study was to examine the effects of dosage of preoperative opioid use on orthopedic knee surgery pain control and postoperative outcomes and complications. Study Design: Observational, retrospective evaluation. Setting: University of Wisconsin Madison hospitals. Methods: The patients underwent orthopedic knee surgery between May 1, 2014 and April 30, 2015. We randomly selected 197 patients and divided them into 2 groups that had preoperative opioid dosages of either low dose ≤ 120 mEq morphine (MME) or high dose >120 MME. Of 197 patients, 100 were in the low dose morphine group, whereas 97 were high dose. The cutoff at 120 MME was calculated to be the median dosage across all patients. The primary outcomes were compared, differences in postoperative pain control, and range of motion (ROM). Secondary outcomes included anesthetic complications, length of hospital stay, postoperative opioid dose, and postoperative complications. Results: There were no statistically significant differences between the groups with regard to postoperative pain control, ROM, and immediate postoperative complications. Both groups showed similar length of hospitalization (2.199 to 2.304 days; P = 0.374), rate of postoperative infection, and joint intervention. The high dose group was more likely to have postoperative hemarthrosis and emergency department (ED) visits. However, the low dose group was more likely to have hypertension concurrently. Limitations: Because the study length was restricted to one year, the lack of data on longer term prognosis may limit extrapolation of data. Subjectivity of pain is difficult to measure and compare objectively. This study was not randomized prospectively, which may bias certain results due to unobserved differences. Conclusions: Preoperative opioid dose did not affect postoperative pain control or ROM in patients who received knee surgeries. Higher preoperative opioid doses were associated with more hemarthrosis and ED visits. Further exploration into quality of life indices and surgical complications such as need for revision may be a fruitful avenue. Key words: Opioids, analgesic, knee pain, total knee replacement, knee surgery, preoperative opioids, knee outcomes

Sublingual buprenorphine on regular intervals in postoperative pain due to total hip replacement

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S144
Author(s):  
P. Sjøgren ◽  
M. Laub ◽  
H. Grønnebech ◽  
C. Sørensen ◽  
N. Valentin
Keyword(s):  
Postoperative Pain ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Sublingual Buprenorphine ◽  
Total Hip

scholarly journals The Relevance of the OPRM1 118A>G Genetic Variant for Opioid Requirement in Pain Treatment: A Meta-Analysis

2019 ◽  
Vol 4 (22;4) ◽  
pp. 331-340
Author(s):  
Haichen Chu
Keyword(s):  
Genetic Variation ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Genetic Variant ◽  
Pain Treatment ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Individual Response ◽  
Opioid Dose ◽  
Meta Analyses

Background: There is obvious difference in individual response to opioids. Many studies have examined the correlation between the μ-opioid receptor 1 (OPRM1) 118A>G genetic variation and opioid requirement in pain treatment, but the conclusion remains elusive. Objectives: To investigate whether the OPRM1 118A>G genetic variation is associated with the opioid requirement. Study Design: Systematic review and meta-analysis. Methods: PubMed, Cochrane library, and EMBASE databases were systematically searched up to May 5, 2018, using the keywords “OPRM1,” “genetic variant,” “opioid,” and “pain” to identify reviews or meta-analyses on this topic. Two independent reviewers performed the data extraction and assessed study quality. The authors investigated the standardized mean difference (SMD) of opioid requirement between AA homozygotes and G allele carriers. The authors also examined the association between the OPRM1 118A>G genetic variation and adverse effects such as nausea and vomiting. Potential bias was assessed using the Egger’s test and the Begg’s test. Results: A total of 530 articles were retrieved from the databases searched, and 36 studies involving 8,609 patients were included in the final analysis. G allele carriers required a higher mean opioid dose (SMD: 0.17; 95% confidence interval [CI]: [0.12, 0.22]; P < 0.001) and displayed less nausea risk difference (RD): –0.04; 95% CI: [–0.06, –0.01]), but the incident rate of vomiting has no relationship with the genetic variant than AA homozygotes in a random-effects meta-analysis. Although there was no evidence of publication bias (Begg’s test: P = 0.333; Egger’s: P = 0.561), heterogeneity was present among studies (I2 = 54.3%). In the subgroup meta-analyses, there was also significance observed in the postoperative pain setting. Limitations: In all of the articles reviewed, postoperative pain and cancer pain were mostly discussed except for one in other pain setting. Conclusions: In this meta-analysis, the results indicate the OPRM1 A118G polymorphism was associated with the opioid requirement and the adverse effects in pain treatment especially in postoperative pain. This may provide valuable information for clinicians to adopt personalized pain management by properly using the opioids in individual patients. Key words: OPRM1, genetic variation, opioid, pain, side effect, review, meta-analysis

scholarly journals Mandatory sublingual buprenorphine for postoperative pain

Anaesthesia ◽  
1984 ◽  
Vol 39 (4) ◽  
pp. 329-334 ◽  
Author(s):  
R. E. S. BULLINGHAM ◽  
G. O'SULLIVAN ◽  
H. J. McQUAY ◽  
P. POPPLETON ◽  
M. ROLFE ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sublingual Buprenorphine

scholarly journals Chronic Smoking is Not Associated with Increased Postoperative Opioid Use in Patients with Lung Cancer or Esophageal Cancer

2018 ◽  
Vol 1 (21;1) ◽  
pp. E49-E55 ◽  
Author(s):  
Tak Kyu Oh
Keyword(s):  
Lung Cancer ◽  
Esophageal Cancer ◽  
Postoperative Pain ◽  
Cigarette Smoking ◽  
Final Analysis ◽  
Cancer Center ◽  
Opioid Use ◽  
Opioid Dose ◽  
Cancer Types ◽  
Chronic Smoking

Background: Chronic smokers show differences in pain sensitivity compared to healthy non-smokers. Yet, no study to date has examined whether smoker status has an effect on postoperative pain. Objective: We aim to examine a possible correlation between preoperative smoking and postoperative opioid dose based on the hypothesis that smokers would use higher doses of opioids to manage increased postoperative pain. Study Design: A retrospective observational cohort study. Setting: The National Cancer Center in Korea. Methods: We examined medical record data for patients who had undergone curative resection for either lung or esophageal cancer (lobectomy or bilobectomy for lung cancer or an Ivor Lewis operation for esophageal cancer) between January 1, 2006 and December 31, 2010. We examined the correlation between the total preoperative average number of packs per day multiplied by years of cigarette smoking (pack-years) and morphine equivalent daily doses administered to patients after surgery, considering each type of cancer both individually and together. Partial correlation and regression analyses were performed to determine the causality of a possible relationship between pack-years of cigarette smoking and postoperative opioid dose. Results: A total of 1,129 patients (871 patients with lung cancer and 258 patients with esophageal cancer) were included in the final analysis. There was no significant correlation between total pack-years of cigarette smoking and postoperative opioid dose for lung cancer, esophageal cancer, or both cancer types combined (r = 0.042, -0.012, and 0.037, respectively). In the analysis of both cancer types combined, video-assisted thoracic surgery (VATS) was associated with an 11.1% decrease in opioid dose (β = -0.111, P = 0.003) and epidural analgesia was associated with a 7.2% increase in opioid dose (β = 0.072, P = 0.042). Limitations: The retrospective design of this study is a limitation. Conclusion: Our study did not observe a correlation between preoperative smoking and postoperative opioid dose in patients with lung or esophageal cancer. Key words: Smoking, postoperative pain, opioid, lung cancer, esophageal cancer, analgesia

scholarly journals Acute Pain Burden and Opioid Dose Requirements after Cesarean Delivery in Parturients with Preexisting Chronic Back Pain and Migraine

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ryu Komatsu ◽  
Michael G. Nash ◽  
Kenneth C. Ruth ◽  
William Harbour ◽  
Taylor M. Ziga ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Postoperative Pain ◽  
Pain Score ◽  
Cesarean Delivery ◽  
Chronic Back Pain ◽  
Weighted Average ◽  
Opioid Use ◽  
Opioid Dose ◽  
Chronic Pain Conditions

Introduction. Preexisting chronic pain has been reported to be a consistent risk factor for severe acute postoperative pain. However, each specific chronic pain condition has unique pathophysiology, and it is possible that the effect of each condition on postoperative pain is different. Methods. This is a retrospective cohort study of pregnant women with preexisting chronic pain conditions (i.e., migraine, chronic back pain, and the combination of migraine + chronic back pain), who underwent cesarean delivery. The effects of the three chronic pain conditions on time-weighted average (TWA) pain score (primary outcome) and opioid dose requirements in morphine milligram equivalents (MME) during postoperative 48 hours were compared. Results. The TWA pain score was similar in preexisting migraine and chronic back pain. Chronic back pain was associated with significantly greater opioid dose requirements than migraine (12.92 MME, 95% CI: 0.41 to 25.43, P = 0.041 ). Preoperative opioid use ( P < 0.001 ) was associated with a greater TWA pain score. Preoperative opioid use ( P < 0.001 ), smoking ( P = 0.004 ), and lower postoperative ibuprofen dose ( P = 0.002 ) were associated with greater opioid dose requirements. Conclusions. Findings suggest women with chronic back pain and migraine do not report different postpartum pain intensities; however, women with preexisting chronic back pain required 13 MME greater opioid dose than those with migraine during 48 hours after cesarean delivery.

Sublingual buprenorphine in postoperative pain relief

Pain ◽  
1984 ◽  
Vol 18 ◽  
pp. S205
Author(s):  
I. Tigerstedt ◽  
P. Dunkel ◽  
T. Tammisto
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Pain Relief ◽  
Sublingual Buprenorphine
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