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Standardized Multimodal Pain Protocol Minimizes Inpatient Opioid Administration in Pediatric Orthopedic Surgery Population.
Iowa Orthop J
January 2025
NYU Langone Orthopedic Hospital, New York, New York, USA.
Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.
View Article and Find Full Text PDFManaging Dual Dependencies: A Case Study of Concurrent Low-Dose Buprenorphine Induction and Rapid Phenobarbital Taper.
J Psychoactive Drugs
January 2025
McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Co-occurring substance use disorders are common in medical settings, yet limited literature exists on concomitant pharmacological management. We present a case where low-dose buprenorphine induction (LDBI) and rapid phenobarbital taper were performed concurrently in a hospital setting to manage co-occurring opioid dependence (on chronic methadone maintenance therapy) and benzodiazepine dependence (prescribed alprazolam). The simultaneous management was well-tolerated and completed with minimal complications, successfully enabling candidacy for the patient's preferred disposition.
View Article and Find Full Text PDFTrends in Opioid Prescriptions to Opioid-Naïve Patients by Oral and Maxillofacial Surgeons in Massachusetts 2012-2022.
J Oral Maxillofac Surg
December 2024
Corresponding Member of the Faculty, Harvard School of Dental Medicine, and Visiting Surgeon, Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
Background: Many oral and maxillofacial surgery patients are young, healthy adults who are opioid-naïve. Over-prescribing opioids increases the risk of subsequent misuse and diversion.
Purpose: The purpose of this study was to measure and compare opioid prescriptions to opioid naïve and nonnaïve patients by oral and maxillofacial surgeons in Massachusetts from 2012 to 2022.
Impact of Non-Hepatectomy Opioid Reduction Efforts on Post-Hepatectomy Opioid Prescriptions: Analysis of 2,005 Patients.
J Am Coll Surg
January 2025
Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
Introduction: Pathway-driven, post-pancreatectomy opioid reduction interventions have proven effective and sustainable and may have a "halo effect" on other major abdominal cancer operations. This study's aim was to analyze the sequential effects of expanding opioid reduction efforts from pancreatectomy on opioids prescribed after hepatectomy.
Methods: This is a retrospective cohort study utilizing data from the electronic health record and a prospective quality improvement database for consecutive hepatectomy patients (09/2016-02/2024).
Surgical Opioid Stewardship: From the Epidemic Through the Pandemic and Beyond.
J Am Coll Surg
January 2025
Surgical Oncology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Background: In response to the opioid epidemic, prescribing guidelines and statewide surgical opioid management programs were initiated in 2018-19. This analysis aims to document the sustainability of a regional opioid stewardship consortium through the pandemic and beyond.
Study Design: From September 2019 through August 2023, 15 NSQIP hospitals in two states gathered opioid-specific variables on patients undergoing 12 procedures.
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