Predictors of Weeks to Opioid Cessation after Lumbar Fusion: A Prospective Cohort Study.

Background: Although the use of prescription opioid analgesics to treat acute, postoperative pain is a well-established practice, the role of opioids in the management of persistent, postoperative pain remains ill-defined. Nevertheless, high rates of long-term opioid use following lumbar fusion have been reported.

Aim: The goal of this prospective, longitudinal study was to identify predictors of weeks to opioid cessation in a cohort of patients undergoing elective lumbar fusion.

The Biopsychosocial Model of Low Back Pain and Patient-Centered Outcomes Following Lumbar Fusion.

Lumbar fusion is a surgical procedure performed to eliminate painful motion in a spinal segment by joining, or fusing, two or more vertebrae. Although the surgery has a high rate of producing radiographic fusion, many patients report pain, functional disability, an inability to return to work, and prolonged opioid pain reliever use following the procedure. Using the biopsychosocial model of low back pain as a framework, this review of the literature describes the biological, psychological, and social factors that have been associated with these negative outcomes.

Perception of Nursing Education Uses of Second Life by Graduate Nursing Students.

Although virtual reality platforms, such as Second Life, have been used in academic settings for more than a decade, little is known about how students perceive or adapt to this technology. This article presents the results of a research study that examined the experiences and perceptions of graduate nursing students as they explored the educational applications of Second Life. The students created avatars, interacted with one another in the virtual world, explored healthcare and educational uses, and maintained a reflective blog (online journal) of their experiences.

Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.

Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan.