Urology
The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
Published: December 2023
Objective: To assess the risk of persistent opioid use following various urologic procedures in adolescents and young adults.
Materials And Methods: The TriNetX LLC Diamond Network was queried for patients aged 13-21years who underwent pyeloplasty, hypospadias repair, inguinal hernia repair, inguinal orchiopexy, hydrocelectomy, or circumcision. Cohorts of patients prescribed and not prescribed postoperative opioids were created and propensity-matched for age, race/ethnicity, psychiatric diagnoses, and preoperative pain diagnoses. The primary outcome was new persistent opioid use, defined as new opioid use 3-9months after index procedure without another surgery requiring anesthesia during the postoperative timeframe.
Results: Of 32,789 patients identified, 66.0% received a postoperative opioid prescription. After propensity score matching for each procedure, 18,416 patients were included: 197 for pyeloplasty, 469 for hypospadias repair, 1818 for inguinal hernia repair, 2664 for inguinal orchiopexy, 534 for hydrocelectomy, and 3526 for circumcision. Overall, 0.41% of patients who did not receive postoperative opioids developed new persistent opioid use, whereas 1.69% of patients who received postoperative opioids developed new persistent opioid use (P < .05). Patients prescribed postoperative opioids had statistically higher odds of developing new persistent opioid use for hypospadias repair (RR: 17.0; 95% CI: 2.27-127.2), inguinal orchiopexy (RR: 3.46; 95% CI: 1.87-6.4), inguinal hernia repair (RR: 2.18; 95% CI: 1.07-4.44), and circumcision (RR: 4.83; 95% CI: 2.60-8.98).
Conclusion: The use of postoperative opioids after urological procedures in adolescents and young adults is associated with a significant risk of developing new persistent opioid use.
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http://dx.doi.org/10.1016/j.urology.2023.08.031 | DOI Listing |
Drug Alcohol Depend
December 2024
School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Background: The potential risks of prenatal cannabis use may vary depending on how cannabis is administered, but little is known about modes of prenatal cannabis use. This study characterized prevalence and sociodemographic correlates of modes of prenatal cannabis use in California.
Methods: This cross-sectional study included patients with pregnancies between January 1, 2021 and December 31, 2022 in a large healthcare system (3507 pregnancies [3454 individuals]) who self-reported prenatal cannabis use and mode of use (smoke, vape, edibles, dabs, and topicals) during universal screening at entrance to prenatal care.
Pain
February 2025
Department and Graduate Institute of Business Administration, National Taiwan University, Taipei, Taiwan.
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, AZ.
Objectives: Buprenorphine is becoming a key component of prehospital management of opioid use disorder (OUD). It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine.
View Article and Find Full Text PDFChronic pain lasting more than three months or persisting after normal healing is a significant global health issue. In a healthcare system, it is crucial to ensure proper chronic pain management. Traditional pharmacological and non-pharmacological pain management techniques may not fully meet the requirements of physicians regarding effectiveness and safety.
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