An Acute Pain Service experience initiating methadone for opioid use disorder in hospitalized patients with acute pain.

Objective: Inform readers of the use of a clinical pathway that includes initiation of methadone in hospitalized patients with acute pain who have untreated opioid use disorder (OUD).

Design: A retrospective chart review with frequency distributions and descriptive statistics calculated to describe demo-graphic and clinical characteristics of the sample.

Setting: Urban academic hospital.

Opioid Guidelines Are a Necessary Response to the Opioid Crisis.

Guidelines for opioid prescribing in noncancer pain have proliferated since the opioid crisis in the United States became widely recognized. The recently published Centers for Disease Control (CDC) guidelines for opioid prescribing have been controversial. Many of these concerns arise from underestimation of the scale of the opioid crisis, as well as misunderstanding what the guidelines actually say.

Vascular risk in migraineurs: interaction of endothelial and cortical excitability factors.

Background: Migraine is a common primary headache disorder occurring predominantly in a young, relatively healthy population.

Results: There is a growing literature on associations between migraine, especially migraine with aura, and ischemic stroke as well as other vascular events. Migraine as a risk factor for vascular disease and connections between migraine and endothelial, structural, and genetic risk are reviewed.

Needle echogenicity in ultrasound-guided lumbar spine injections: a cadaveric study.

Background: Echogenicity of regional anesthesia needles has been tested on different preclinical models; however, previous studies were done in an ideal experimental setting utilizing high-frequency insonation and superficially located targets. Because steep-angle deep injections are typically required for spinal and other chronic pain procedures, and low-frequency transducers are used, further feasibility study is warranted.

Objectives: To determine effectiveness of steep-angle deep injections, typically required for spinal and other chronic pain procedures.

Opioids in the management of HIV-related pain.

Background: Human Immunodeficiency Virus (HIV) patients have an increased rate of chronic pain, particularly peripheral neuropathy. This disease burden causes considerable disability and negatively affects quality of life. Pain is undertreated and more complex to manage in these patients for a number of reasons, including complex anti-retroviral drug regimens, higher risks of side effects, and higher rates of comorbid psychiatric illness and substance abuse.