scholarly journals When Prescribing Pain Medications, Think About Qtc Index

2017 ◽  
Vol 02 (02) ◽  
Author(s):  
Catarci T
Keyword(s):  
Pain Medications

Written Prescription for Over-the-Counter Nonopioid Pain Medications Does Not Increase the Likelihood of Use after Ambulatory Hand and Upper Extremity Surgery

2020 ◽  
Author(s):  
Daniel J. Lynch ◽  
James S. Lin ◽  
Kanu S. Goyal
Keyword(s):  
Postoperative Pain ◽  
Soft Tissue ◽  
Upper Extremity ◽  
Pain Control ◽  
Control Program ◽  
Postoperative Pain Control ◽  
Over The Counter ◽  
Unequal Variance ◽  
Pain Medications ◽  
Medication Consumption

Abstract Introduction This study looked to determine how providing written prescriptions of nonopioids affected postoperative pain medication usage and pain control. Materials and Methods Patients undergoing hand and upper-extremity surgery (n = 244) were recruited after the implementation of a postoperative pain control program encouraging nonopioids before opioids. Patients were grouped based on procedure type: bone (n = 66) or soft tissue (n = 178). Patients reported postoperative medication consumption and pain control scores. Two-tailed t-tests assuming unequal variance were performed to look for differences in postoperative pain control and medication consumption between those who were and were not given written prescriptions for nonopioids. Results For both soft tissue and bone procedure patients, a written prescription did not significantly affect patients’ postoperative pain control or medication consumption. Regardless of receiving a written prescription, patients who underwent soft tissue procedures consumed significantly more daily nonopioids than opioids. Conclusion Receiving written prescriptions for nonopioids may not have a significant effect on postoperative pain control or medication consumption. Patients undergoing soft tissue hand and upper extremity procedures may be more likely to consume more daily nonopioids than opioids postoperatively compared to bone procedure patients regardless of whether they receive a written prescription for nonopioids.

Drug policy and control at the international level

2018 ◽  
Author(s):  
Thomas F. Babor ◽  
Jonathan Caulkins ◽  
Benedikt Fischer ◽  
David Foxcroft ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Drug Control ◽  
Prescription Medications ◽  
Access To Treatment ◽  
Illicit Markets ◽  
Pain Medications ◽  
Almost All ◽  
And Control ◽  
Illicit Trafficking

International drug control efforts are designed to coordinate domestic laws with international activities that regulate or limit the supply of psychoactive substances. These efforts are organized around three main drug control treaties that almost all countries have ratified in order to prevent illicit trafficking and other drug-related crime, while at the same time allowing access to prescription medications. The effects of the system have been evaluated mostly in terms of the ability to eliminate illicit markets and supply. The gross imbalance in world consumption of legal opiates is a pointer to the limited availability of effective pain medications in many low-income countries, with 80% of the world’s population having either no or inadequate access to treatment for moderate or severe pain.

scholarly journals Psychotropic and pain medication use in individuals with traumatic brain injury—a Swedish total population cohort study of 240 000 persons

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Total Population ◽  
Medication Use ◽  
Population Based ◽  
Pain Medication ◽  
Short Term ◽  
Pain Medications ◽  
Before And After

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.

scholarly journals The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
A. Meier ◽  
J. McGree ◽  
R. Klee ◽  
J. Preuß ◽  
D. Reiche ◽  
...  
Keyword(s):  
Best Practice ◽  
Clinical Status ◽  
Clinical Signs ◽  
Scoring Method ◽  
Pain Medications ◽  
Exponential Decay Model ◽  
History Of ◽  
Consistent Method ◽  
Foot Disease ◽  
New Treatments

Abstract Background Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a ‘normal’ pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, using two different scoring methods. Eighty horses and ponies with suspected HAL were enrolled in a study conducted at 16 veterinary practices across Germany. The severity of laminitis was assessed by independent veterinarians using both the traditional Obel method and a modified Obel method developed by Meier and colleagues. Assessments were made on the day of diagnosis (d 0), then on days 4, 9, 14, 25 and 42 during the intervention period. Pain medications were withheld for 24 h prior to clinical examination in all cases. Results Time to marked improvement from laminitis varied between individuals, but was difficult to monitor accurately using the Obel method, with the median grade being 2/4 on days 0 and 4, then 0/4 from d 9 onwards. More subtle changes could be identified using the Meier method, however, and the median scores were seen to follow the form of an exponential decay model in most horses, improving from 8/12 on d 0, to 0/12 on d 25. Within this composite scoring method, considerable variation was observed in the rate of improvement of individual clinical signs, with the average time taken for each sign to reach a median score of 0 ranging from 4 days (foot lift and weight shifting) to 25 days (gait when turned in a circle) across all 80 horses. Conclusions The Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL, and despite the variability, the pattern of improvement described here should provide a useful benchmark against which individual cases and new treatments can be assessed.

scholarly journals Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement

2020 ◽  
Vol 1 ◽  
Author(s):  
Hunter G. Hoffman ◽  
David R. Patterson ◽  
Robert A. Rodriguez ◽  
Raquel Peña ◽  
Wanda Beck ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Intensity ◽  
Wound Care ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Severe Burn ◽  
Burn Wound ◽  
Absolute Change ◽  
Wound Debridement ◽  
Pain Medications

The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care. Using a randomized between-groups design, participants were randomly assigned to one of two groups, (a) the Control Group = pain medications only or (b) the VR Group = pain medications + virtual reality. A total of 50 children (88% Hispanic) with large severe burns (mean TBSA &gt; 10%) received severe burn wound cleaning sessions. For the primary outcome measure of worst pain (intensity) on Study Day 1, using a between groups ANOVA, burn injured children in the group that received virtual reality during wound care showed significantly less pain intensity than the No VR control group, [mean worst pain ratings for the No VR group = 7.46 (SD = 2.93) vs. 5.54 (SD = 3.56), F(1,48) = 4.29, &lt; 0.05, MSE = 46.00]. Similarly, one of the secondary pain measures, “lowest pain during wound care” was significantly lower in the VR group, No VR = 4.29 (SD = 3.75) vs. 1.68 (2.04) for the VR group, F(1,47) = 9.29, &lt;0.005, MSE = 83.52 for Study Day 1. The other secondary pain measures showed the predicted pattern on Study Day 1, but were non-significant. Regarding whether VR reduced pain beyond Study Day 1, absolute change in pain intensity (analgesia = baseline pain minus the mean of the worst pain scores on Study days 1–10) was significantly greater for the VR group, F(1,48) = 4.88, p &lt; 0.05, MSE = 34.26, partial eta squared = 0.09, but contrary to predictions, absolute change scores were non-significant for all secondary measures.

Comparison of Postoperative Pain between Laser-Assisted Uvulopalatoplasty, Uvulopalatopharyngoplasty, and Radiofrequency Volumetric Tissue Reduction of the Palate

2000 ◽  
Vol 122 (3) ◽  
pp. 402-409 ◽  
Author(s):  
Robert J. Troell ◽  
Nelson B. Powell ◽  
Robert W. Riley ◽  
Kasey K. Li ◽  
Christian Guilleminault
Keyword(s):  
Quantitative Assessment ◽  
Sleep Disordered Breathing ◽  
The Other ◽  
Narcotic Analgesics ◽  
Pain Medications ◽  
Pain Scales ◽  
Analgesic Medication ◽  
The Mean ◽  
Radiofrequency Volumetric Tissue Reduction ◽  
Tissue Reduction

OBJECTIVES: This study compares the posttreatment discomfort between laser-assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty (UPPP), and radiofrequency volumetric tissue reduction (RFVTR) of the palate through the use of visual analog pain scales and a quantitative assessment of the analgesic medication taken. METHODS: In one group, LAUP (n = 10) or UPPP (n = 9) was used to treat patients' snoring or sleep-disordered breathing (SDB), and the other group underwent RFVTR (n = 22). RESULTS: The mean numbers of days with pain after RFVTR, LAUP, and UPPP were 2.6, 13.8, and 14.3 days, respectively. Narcotic analgesics were required in the RFVTR, LAUP and UPPP groups in 9%, 100%, and 100% of the subjects, respectively. The mean number of these days requiring narcotic pain medications for RFVTR, LAUP, and UPPP was 0.2, 11.8, and 12.4 days, whereas the total narcotic equivalent was 0.3, 7.4 and 29.6 days, respectively. CONCLUSION: RFVTR of the soft palate produced less posttreatment pain than LAUP or UPPP. LAUP and UPPP appeared to show little difference in the severity or duration of posttreatment discomfort.

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