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Pharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.
J Clin Med
December 2024
Department of Pharmacy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
: As long-term prescription opioid use is associated with increased morbidity and mortality, timely dose reduction of prescription opioids should be considered. However, most research has been conducted on patients using heroin. Given the differences between prescription and illicit opioid use, the aim of this review was to provide an overview of pharmacological strategies to reduce prescription opioid use or improve clinical outcomes for people who experience long-term prescription opioid use, including those with opioid use disorder.
View Article and Find Full Text PDFEffect of Ultrasound-Guided Extra-Prevertebral Fascial Suprascapular Nerve and Infraclavicular Brachial Plexus Block on Postoperative Analgesia and Phrenic Nerve Function in Shoulder Arthroscopy: A Pilot Study.
J Pain Res
December 2024
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Purpose: The suprascapular nerve is situated between the prevertebral fascia and the superficial layer of deep cervical fascia and on the surface of the middle and posterior scalene muscles before it reaches the suprascapular notch. Consequently, we hypothesized that injecting local anesthetics (LAs) there would introduce a new block approach for blocking the suprascapular nerve, ie, extra-prevertebral fascial block. We assessed the postoperative analgesic effect, as well as the incidence of diaphragmatic paralysis 30 minutes after the block.
View Article and Find Full Text PDFEvaluation of Pain Relief and Opioid Consumption With the Addition of an Erector Spinae Plane Catheter Block After an Interscalene Nerve Block in Arthroscopic Rotator Cuff Repair.
Orthop J Sports Med
December 2024
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Background: The effects of the erector spinae plane (ESP) block and interscalene nerve block (ISNB) on arthroscopic rotator cuff repair (RCR) have been investigated separately.
Purpose: To evaluate whether additional catheterization for the ESP block can decrease acute postoperative pain and opioid consumption above the ISNB and multimodal oral analgesics in patients after arthroscopic RCR.
Study Design: Cohort study; Level of evidence, 3.
Intracellular pocket conformations determine signaling efficacy through the opioid receptor.
bioRxiv
December 2024
Department of Chemistry, Illinois Institute of Technology, Chicago, Illinois 60616, United States.
It has been challenging to determine how a ligand that binds to a receptor activates downstream signaling pathways and to predict the strength of signaling. The challenge is compounded by functional selectivity, in which a single ligand binding to a single receptor can activate multiple signaling pathways at different levels. Spectroscopic studies show that in the largest class of cell surface receptors, 7 transmembrane receptors (7TMRs), activation is associated with ligand-induced shifts in the equilibria of intracellular pocket conformations in the absence of transducer proteins.
View Article and Find Full Text PDFCostoclavicular block as a diaphragm-sparing nerve block for shoulder surgery: a randomized controlled trial.
Korean J Anesthesiol
December 2024
Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, 34943, Republic of Korea.
Backgrounds: Distal nerve block approaches have been explored to reduce hemidiaphragmatic paresis (HDP) more effectively than interscalene block (ISB). However, these approaches are associated with a high incidence of HDP. The costoclavicular block (CCB) provides effective analgesia while reducing HDP.
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