Decreasing Opioid Use Postpartum: A Quality Improvement Initiative.

Objective: To estimate the effects of an inpatient initiative to decrease opioid use among women admitted to labor and delivery.

Methods: We created a multimodal pain power plan with standard therapeutic postpartum activity goals rather than pain goals, tiered order sets with scheduled administration of nonsteroidal antiinflammatory drugs (NSAIDs), and embedded changes into the electronic health record. Before the multimodal pain power plan launch, pain was assessed on a 10-point scale; women received NSAIDs for pain levels of 3 or less and opioids for pain levels higher than 3.

The Therapeutic Activity Goal for Acute Postoperative Pain Management.

Acute pain intensity has conventionally been assessed with a patient self-reported, unidimensional pain scale. This approach can inadvertently underestimate analgesia and result in large cumulative opioid doses and greater dose-dependent side effects and complications. We have thus created the Therapeutic Activity Goal (TAG) as an alternate, more comprehensive way to assess acute postoperative pain, and even more so, to define and determine adequate postoperative analgesia.

Epidural hematoma and intraoperative hemorrhage in a spine trauma patient on Pradaxa (dabigatran).

Study Design: The authors present a case report of a 72-year-old man who presented with back pain and lower extremity weakness after a fall from his roof.

Objective: Use of dabigatran (Pradaxa), a new oral anticoagulant, is rapidly increasing. Spine specialists should aware of this medication's place for the management of patients with spine pathology.

Sutureless avascular meniscal repair with a photoactive naphthalimide compound: a preliminary animal study.

Purpose: The purpose of this study was to evaluate the ability of 2 new photoactive naphthalimide compounds to repair a lesion in the avascular zone of the meniscus.

Type Of Study: In vivo animal study.

Methods: Ten Barbados sheep were used as the animal model.

The results of arthroscopic lavage and debridement of osteoarthritic knees based on the severity of degeneration: a 4- to 6-year symptomatic follow-up.

Purpose: A clinically and arthroscopically oriented staging system based on the severity of the degenerative process has been used in the assessment of the results of arthroscopic lavage and debridement of osteoarthritic (OA) knees.

Type Of Study: Retrospective case series.

Methods: For eighteen months, commencing January 1995, every case of previously untreated OA referred for definitive treatment was clinically classified into 1 of 4 stages of increasing degeneration.