Prescription opioids, particularly for treating musculoskeletal pain, are a significant contributor to the opioid epidemic in North America. There is also evidence to suggest that chronic use of opioids is associated with poor outcomes after orthopedic surgery. However, whether this association is relevant in foot and ankle surgery is still unclear. Accordingly, a systematic review of the literature was undertaken to assess the impact of preoperative opioid use in patients undergoing foot and ankle surgery concerning postoperative pain, complications, and postoperative opioid dependence. Four databases, including EMBASE, MEDLINE, PubMed, and CINAHL, were searched to March 2022 for studies reporting preoperative opioid use and its effect on postoperative outcomes or opioid use after foot and ankle surgery. A total of 22,092 patients were included in the final synthesis of 8 studies. Most of which were level 3 evidence (5 studies). Around 18% of the patients used opioids preoperatively. Preoperative opioid use was associated with more quantities and prolonged use of opioids postoperatively. Two studies showed an increased risk of complications postoperatively in patients who used opioids preoperatively compared to the nonopioid group. Preoperative opioid use in patients undergoing foot and ankle surgeries is associated with increased and prolonged use of opioids postoperatively and may therefore predict the potential for misuse.
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http://dx.doi.org/10.1053/j.jfas.2023.10.003 | DOI Listing |
Background: While concomitant opioid and benzodiazepine use is discouraged due to an increased risk of sedation/overdose, the extent of perioperative opioid utilization in hand surgery patients already using benzodiazepines is unknown.
Methods: Using an administrative claims database, we identified adults undergoing carpal tunnel, DeQuervain, or trigger finger release, palmar fasciectomies, ganglion/mucoid cyst removals, and hand/wrist soft tissue mass excisions from 2011 to 2021. We identified opioid-naive patients with a benzodiazepine prescription within 90 days before surgery.
Cureus
December 2024
Department of Medical-Clinical Disciplines, General Surgery, Titu Maiorescu University of Bucharest, Bucharest, ROU.
Introduction: Colorectal cancer (CRC) is one of the most common cancers occurring globally. Surgery for CRC often extends hospital stays due to complications, as patients must meet nutritional needs and regain mobility before discharge. Longer hospital stays, required for extended monitoring and care, can increase the risk of further complications, creating a cycle where extended stays lead to more issues.
View Article and Find Full Text PDFObjective: To evaluate the impact of peri-incisional liposomal bupivacaine (LB) on postoperative pain scores, opioid use after soft tissue surgeries, and incidence of incision site complications in dogs.
Methods: Client-owned dogs (n = 83) were enrolled in a randomized, blinded, placebo-controlled clinical study for dogs undergoing a variety of soft tissue surgical procedures between March 31, 2021, and August 18, 2022. After incision closure, an injection of a placebo (0.
Reg Anesth Pain Med
January 2025
Division of Pain Management, University Hospitals, Cleveland, Ohio, USA.
Background: To provide recommendations on risk mitigation, diagnosis and treatment of infectious complications associated with the practice of regional anesthesia, acute and chronic pain management.
Methods: Following board approval, in 2020 the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) commissioned evidence-based guidelines for best practices for infection control. More than 80 research questions were developed and literature searches undertaken by assigned working groups comprising four to five members.
Med Sci Monit
January 2025
Department of Anesthesiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.
BACKGROUND Butorphanol, an opioid receptor agonist and antagonist, is widely used for post-cesarean section analgesia in the form of intravenous or intramuscular injection, but nasal sprays are less used. This study aimed to evaluate the analgesic effect of butorphanol nasal spray on uterine contraction pain after cesarean section and explore its effect on postpartum prolactin secretion. MATERIAL AND METHODS We randomly divided 120 patients scheduled for cesarean section into 3 groups (40 per group): intranasal saline (control), butorphanol intranasal (BI), and butorphanol pumped intravenously (BV).
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