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Opioid Consumption Following Isolated and Recurrent Shoulder Dislocation and Reduction.
J Shoulder Elbow Surg
January 2025
Department of Orthopaedics; University Hospital Cleveland Medical Center, Cleveland, OH, USA.
Background: Recurrent shoulder dislocations often lead to multiple encounters for reduction and eventual surgical stabilization, both of which involve exposure to opioids and potentially increase the risk of chronic opioid exposure. The purpose of our study was to characterize shoulder instability and compare pre- and post-reduction opioid usage in singular dislocators (SD) and recurrent dislocators (RD).
Methods: This retrospective study was performed at a single academic institution using a prospective database.
Preoperative Acute Depressive Episodes are Associated with Increased Medication Prescribing and Inpatient Services Following Primary Arthroscopic Rotator Cuff Repair.
Arthroscopy
January 2025
Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, 925 Chestnut Street 5(th) Floor, Philadelphia, PA 19107.
Purpose: The purpose of this study is to compare postoperative healthcare utilization, prescriptions, and shoulder surgery between patients with an acute depressive episode (ADE) and those without an acute depressive episode (NADE) within 3 months before arthroscopic rotator cuff repair.
Methods: Diagnostic and procedural codes were used to identify patients in the TriNetX Research Network at least 18 years of age and underwent arthroscopic rotator cuff repair between January 2010 and November 2021. Patients with a previous rotator cuff repair or diagnosis of recurrent major depressive disorder were excluded.
Intracellular Pocket Conformations Determine Signaling Efficacy through the μ Opioid Receptor.
J Chem Inf Model
January 2025
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 PDFPharmacological 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.
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