background many multimodal analgesia techniques have been tried to provide adequate analgesia for midline incisions extending above and below the umbilicus aiming at limiting the perioperative use of morphine thus limiting side effects. ultrasound (us) guidance made the anesthesiologist reconsider old techniques for wider clinical use. the rectus sheath block (rsb) is a useful technique under-u...

Cancer pain is generally treated with pharmacological measures, relying on using opioids alone or in combination with adjuvant analgesics. Weak opioids are used for mild-to-moderate pain as monotherapy or in a combination with nonopioids. For patients with moderate-to-severe pain, strong opioids are recommended as initial therapy rather than beginning treatment with weak opioids. Adjunctive the...

BACKGROUND This study's objectives were to evaluate whether WCB claimants with conditions requiring certain surgical procedures are more likely to be prescribed outpatient opioids than other Manitobans and whether those prescribed opioids are more likely to still be on opioid medications 6 months post procedure. METHODS We compared 7,246 WCB claims for a number of surgical procedures to 65,03...

In most cancer patients, pain is successfully treated with pharmacological measures using opioid analgesics for moderate to severe pain (strong opioids) alone or in combination with adjuvant analgesics (coanalgesics). Opioids for mild to moderate pain (weak opioids) are usually recommended in the treatment of cancer pain of mild to moderate intensity. There is a debate whether the second step o...

North America is currently facing an opioid epidemic. Opioid overdose deaths have increased 200% since 2000, and in 2014, 28,647 drug-poisoning deaths were attributed to some type of opioid. Multiple sources of opioids contribute to this growing problem and include prescription opioids (including natural and semisynthetic opioids, eg, oxycodone, hydrocodone), methadone, and other synthetic opio...

BACKGROUND Opioids can contribute to postoperative desaturation. Short-acting opioids, titrated to need, may cause less desaturation than longer-acting opioids. We thus tested the primary hypothesis that long-acting patient-controlled intravenous opioids are associated with more hypoxemia (defined as an integrated area under a postoperative oxyhemoglobin saturation of 95%) than short-acting opi...

BACKGROUND Chronic noncancer pain (CNCP) is a major health problem, for which opioids provide one treatment option. However, evidence is needed about side effects, efficacy, and risk of misuse or addiction. METHODS This meta-analysis was carried out with these objectives: to compare the efficacy of opioids for CNCP with other drugs and placebo; to identify types of CNCP that respond better to...

Opioid abuse has increased in the last decade, primarily as a result of increased access to prescription opioids. Physicians are also increasingly administering opioid analgesics for noncancer chronic pain. Thus, knowledge of the long-term consequences of opioid use/abuse has important implications for fully evaluating the clinical usefulness of opioid medications. Many studies have examined th...

Objective To assess prevalence rates and correlates of problematic use of prescription opioids and medicinal cannabis (MC) among patients receiving treatment for chronic pain. Design Cross-sectional study. Setting Two leading pain clinics in Israel. Subjects Our sample included 888 individuals receiving treatment for chronic pain, of whom 99.4% received treatment with prescription opioids...

BACKGROUND Obtaining analgesic narcotics from multiple prescribers is sometimes called 'doctor-shopping,' implying abuse. If the use of multiple prescribers can be used as an indicator for abuse, it would be a convenient way to study abuse in large populations. OBJECTIVE To assess multiple prescribers as an indicator of abuse by relating quantity of opioids obtained by older Norwegians to num...