Relevant bibliographies by topics / Opioids

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Opioids'

Author: Grafiati
Published: 4 June 2021
Last updated: 15 June 2025

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Journal articles on the topic "Opioids"

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Kuechly, Henry, Sarah Kurkowski, John Bonamer, Brian Newyear, Brian Johnson, and Brian Grawe. "Opioid use and disposal at 2 weeks post-surgery: Brief communication regarding excess opioids and disposal habits." Journal of Opioid Management 20, no. 2 (2024): 103–7. http://dx.doi.org/10.5055/jom.0854.

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Objective: To measure the number of unused prescription opioids and disposal habits of patients following orthopedic shoulder surgery. Design: A prospective observational study. Setting: Academic orthopedic sports medicine department. Patients: Sixty-seven patients undergoing shoulder surgery. Interventions: Nine-question opioid use questionnaire. Main outcome measures: Responses to an opioid use questionnaire were collected at 2 weeks post-surgery. Outcomes of interest included the amount of initial opioid prescription used and the disposal of excess opioids. Results: Sixty-seven patients completed the opioid use questionnaire. Forty-six (68.7 percent) patients reported having excess opioids at 2 weeks. Of the 46 patients with excess opioids, 57 percent disposed of the excess, and 43 percent planned to keep their opioids. Conclusion: Two-thirds of the patients reported having excess opioids, highlighting the issue of an overabundance of unused prescription opioids in America. Utilization of opioid-free pain management strategies and drug disposal kits should be explored to reduce the number of unused and improperly disposed opioids.
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Hirai, Risako, and Yoshihiro Uesawa. "Analysis of Opioid-Related Adverse Events in Japan Using FAERS Database." Pharmaceuticals 16, no. 11 (2023): 1541. http://dx.doi.org/10.3390/ph16111541.

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Adverse events associated with opioid use in palliative care have been extensively studied. However, predicting the occurrence of adverse events based on the specific opioid used remains difficult. This study aimed to comprehensively analyze the adverse events related to µ-opioid receptor stimulation of opioids approved in Japan and investigate the tendencies of adverse event occurrence among different opioids. We utilized the FDA Adverse Event Reporting System database to extract reported adverse events for opioids approved in Japan. Cluster analysis was performed on reporting odds ratios (RORs) of adverse event names among opioids to visualize relationships between opioids and adverse events, facilitating a comparative study of their classifications. We calculated the RORs of adverse events for the target opioids. Cluster analysis based on these RORs resulted in five broad clusters based on the reported adverse events: i.e., strong opioids, weak opioids, loperamide, tapentadol, and remifentanil. This study provides a comprehensive classification of the association between μ-opioid-receptor-stimulating opioids and adverse events.
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Madden, Kevin, Akhila Sunkepally Reddy, Maxine Grace De la Cruz, and Eduardo Bruera. "Patterns of storage, use, and disposal of prescription opioids by parents of children with cancer." Journal of Clinical Oncology 37, no. 31_suppl (2019): 114. http://dx.doi.org/10.1200/jco.2019.37.31_suppl.114.

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114 Background: Multiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents. We investigated whether parents of children with cancer that were prescribed opioids practiced safe storage, use, and disposal techniques. Methods: We conducted a prospective cross-sectional survey of parents whose children were prescribed opioids and asked them about their patterns of storage, use, and disposal of prescription opioids. Results: Virtually all parents (106/109, 97%) completed the survey. Most parents (95/106, 90%) did not store opioids safely. Six of 106 parents (6%) gave their child's opioid pain medication to someone else with pain, and 3 of 106 parents (3%) personally took some of their child’s opioid. Parents who personally took their child’s opioid ( P = .01) or gave it to another person ( P < .001) were more likely to use opioids unsafely with their child. A minority of parents (22/106, 21%) did not use opioids safely in their child. A small number of parents (3/22, 14%) did not dispose of opioids safely. Conclusions: Universal education about the safe, use, and disposal of opioids should be adopted when prescribing opioids. Pediatricians need to maintain vigilance about the nonmedical use of prescription opioid use by parents of children.
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Gavidia, R., A. L. Meng, A. Emenike, et al. "0723 Associations Between Opioids, Non-Opioids and Central Sleep Apnea: A Case-Control Study." Sleep 43, Supplement_1 (2020): A275. http://dx.doi.org/10.1093/sleep/zsaa056.719.

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Abstract Introduction Opioids are known to contribute to central sleep apnea (CSA), as they depress responsiveness to carbon dioxide and hypoxia. However, the role of non-opioid medications (antihistamines, myorelaxants, neuroleptics, antidepressants, and hypnotics) in CSA remains unclear. Given the hypothesized impact of non-opioids on the central nervous system, we examined associations between opioid and non-opioid medications and CSA. Methods Among all adults who underwent polysomnography testing at the University of Michigan’s Sleep Center between 2013-2018 (n=10,479), we identified 105 cases of CSA. Of these patients, we randomly selected 300 controls. Demographic and health characteristics, use of medications were obtained from medical charts. We classified study participants into three categories based on medication use: non-opioids only, opioids alone or in combination with non-opioids, and none. CSA was defined as a binary outcome using polysomnographic criteria as per the International Classification of Sleep Disorders-Third Edition. We used logistic regression to examine associations between medication use and CSA. Results Among participants, male:female ratio was 1:1 with a mean age of 49 (±14.3 SD) years. Opioid use alone was rare (4%), but more common in combination with non-opioids (17%), while the exclusive use of non-opioids was found among 38%. In adjusted analyses for age and sex, those who used non-opioid alone were less likely to have a CSA diagnosis (OR=0.88, (95% CI 0.5-1.6); however, the use of opioids (alone or in combination with non-opioids) was associated with a 4-fold higher odds of CSA. Conclusion These data suggest that non-opioids have a protective influence on CSA. Conversely, opioids, alone, or in combination with non-opioids, were associated with increased CSA risk, that may be attributed to opioids alone, or to opioids and non-opioids interactions. However, as opioids were mostly co-prescribed with non-opioids, the sole effect of opioids from the synergistic effect with non-opioids are difficult to disentangle. Support Dr. Gavidia was supported by a T32 Post-Doctoral Fellowship in Neuroscience NIH/NINDS T32 NS 007222
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Wang, Xiaqing, Chongyu Bao, Zhenjiang Li, Lupeng Yue, and Li Hu. "Side Effects of Opioids Are Ameliorated by Regulating TRPV1 Receptors." International Journal of Environmental Research and Public Health 19, no. 4 (2022): 2387. http://dx.doi.org/10.3390/ijerph19042387.

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Humans have used opioids to suppress moderate to severe pain for thousands of years. However, the long-term use of opioids has several adverse effects, such as opioid tolerance, opioid-induced hyperalgesia, and addiction. In addition, the low efficiency of opioids in controlling neuropathic pain limits their clinical applications. Combining nonopioid analgesics with opioids to target multiple sites along the nociceptive pathway may alleviate the side effects of opioids. This study reviews the feasibility of reducing opioid side effects by regulating the transient receptor potential vanilloid 1 (TRPV1) receptors and summarizes the possible underlying mechanisms. Blocking and activating TRPV1 receptors can improve the therapeutic profile of opioids in different manners. TRPV1 and μ-opioid receptors are bidirectionally regulated by β-arrestin2. Thus, drug combinations or developing dual-acting drugs simultaneously targeting μ-opioid and TRPV1 receptors may mitigate opioid tolerance and opioid-induced hyperalgesia. In addition, TRPV1 receptors, especially expressed in the dorsal striatum and nucleus accumbens, participate in mediating opioid reward, and its regulation can reduce the risk of opioid-induced addiction. Finally, co-administration of TRPV1 antagonists and opioids in the primary action sites of the periphery can significantly relieve neuropathic pain. In general, the regulation of TRPV1 may potentially ameliorate the side effects of opioids and enhance their analgesic efficacy in neuropathic pain.
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Ernawati, Desak Ketut, and Agata Widatama. "The Nature of Opioids Used as Pain Management in A Public Hospital in Bali." Jurnal Ilmiah Medicamento 11, no. 1 (2025): 1–6. https://doi.org/10.36733/medicamento.v11i1.10105.

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Opioids are the mainstay of pain management, particularly in chronic pain-related and nonrelated cancer. Studies have shown that the number of opioids used globally varies. It was used excessively in some parts, while in others, it was underused. Little study is known on how opioids are used in Indonesia. This study aimed to identify indications of opioids prescribed and types of opioids used, as well as assess the nature of opioid therapy as pain management for chronic and non-related cancer. This retrospective study was conducted in a public hospital in Bali, Indonesia. Data was collected from all inpatients who received opioids in the hospital from 2018 to 2020. Patients’ age, gender, as well as opioid information such as types of opioids and used for treatment for cancer or non-cancer patients, were pooled and analyzed descriptively. This study found that fentanyl injection was the most opioid prescribed by anesthesiologists as preoperative medications. Opioids were prescribed mostly for non-cancer patients, and limited opioids were prescribed for cancer patients. Future research is required to evaluate factors that influence opioid prescriptions in hospitals.
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TRAORE, Karim, Bourama KEITA, Abdouramane Traoré, et al. "Knowledge and Attitudes of Medical and Pharmacy Graduates about Opioids Prescription and Dispensation in 2022 in Bamako, Mali." Journal of Drug Delivery and Therapeutics 14, no. 9 (2024): 131–36. http://dx.doi.org/10.22270/jddt.v14i9.6801.

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Opioids are medications with analgesic properties used primarily as painkillers. Nowadays, off-label uses (non-medical use, prolonged use, misuse and use without a medical supervision) are common inducing drug dependence with harmful consequences including substance-induced psychosis or pharmacopsychosis. In a cross-sectional study from February to June 2021, we used a questionnaire to collect information on the knowledge of interns and doctors trained in the Faculty of Medicine and Dental Medicine and the Faculty of Pharmacy at the University of Sciences, Bamako Techniques and Technologies (USTTB) on opioids in eight (8) public health facilities (5 university hospitals and 3 district hospitals) in Bamako. We analyzed the data with SPSS software version 25.0. A total of 400 health workers participated in the study with 62.5% of medical students (250/400), 31.0% of pharmacy students (124/400) and 6.5% of general practitioners (26/400). More than 70.0% of our respondents were aware that there is a regulatory framework for prescribing and dispensing opioids in Mali. Level 2 opioids were dispensed in 29.0% of cases at the patient’s verbal request and 30.6% by telephone. However, level 3 opioids were dispensed in 0.8% of cases at the patient’s verbal request and in 3.2% of cases by telephone call. Medical students in 60.0%, pharmacy students in 64.5% and general practitioners in 50.0% had very good knowledge about the risks of opioid use. For 23.0%, general practitioners had at least a good knowledge of opioid indications. Participants had a good understanding of the risks and benefits of opioids. Keywords: Attitudes, Knowledge, Opioïds, Mali
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Oyler, PharmD, Douglas R., Kristy S. Deep, MD, and Phillip K. Chang, MD. "Opioid use in the acute setting: A survey of providers at an academic medical center." Journal of Opioid Management 14, no. 3 (2018): 203–10. http://dx.doi.org/10.5055/jom.2018.0450.

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Objective: To examine attitudes, beliefs, and influencing factors of inpatient healthcare providers regarding prescription of opioid analgesics.Design: Electronic cross-sectional survey.Setting: Academic medical center.Participants: Physicians, advanced practice providers, and pharmacists from a single academic medical center in the southeast United States.Main Outcome Measures: Respondents completed survey items addressing: (1) their practice demographics, (2) their opinions regarding overall use, safety, and efficacy of opioids compared to other analgesics, (3) specific clinical scenarios, (4) main pressures to prescribe opioids, and (5) confidence/comfort prescribing opioids or nonopioids in select situations.Results: The majority of the sample (n = 363) were physicians (60.4 percent), with 69.4 percent of physicians being attendings. Most respondents believed that opioids were overused at our institution (61.7 percent); nearly half thought opioids had similar efficacy to other analgesics (44.1 percent), and almost all believed opioids were more dangerous than other analgesics (88.1 percent). Many respondents indicated that they would modify a chronic regimen for a high-risk patient, and use of nonopioids in specific scenarios was high. However, this use was often in combination with opioids. Respondents identified patients (64 percent) and staff (43.1 percent) as the most significant sources of pressure to prescribe opioids during an admission; the most common sources of pressure to prescribe opioidson discharge were to facilitate discharge (44.8 percent) and to reduce follow-up requests, calls, or visits (36.3 percent). Resident physicians appear to experience more pressure to prescribe opioids than other providers. Managing pain in patients with substance use disorders and effectively using nonopioid analgesics were the most common educational needs identified by respondents.Conclusion: Most individuals believe opioid analgesics are overused in our specific setting, commonly to satisfy patient requests. In general, providers feel uncomfortable prescribing nonopioid analgesics to patients.
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Qeadan, Fares, Erin F. Madden, Nana A. Mensah, et al. "Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska Native populations from 1999 to 2019: a retrospective longitudinal ecological study." BMJ Open 12, no. 5 (2022): e053686. http://dx.doi.org/10.1136/bmjopen-2021-053686.

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ObjectivesThe rate of drug overdose deaths in the USA has more than tripled since the turn of the century, and rates are disproportionately high among the American Indian/Alaska Native (AI/AN) population. Little is known about the overall historical trends in AI/AN opioid-only and opioid/polysubstance-related mortality. This study will address this gap.DesignThis is a retrospective longitudinal ecological study.SettingUS death records from 1999 to 2019 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research.ParticipantsUS non-Hispanic AI/AN people age 12 years and older.MeasuresThe primary outcomes, identified via the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes, included overdose deaths due to (1) opioids only, opioids in combination with any other substance, all-opioid related overdoses; (2) combinations of opioids and alcohol, opioids and methamphetamine, opioids and cocaine, opioids and benzodiazepines; and (3) specific types of opioids.ResultsFrom 1999 to 2019, opioid-only mortality rates increased from 2.8 to 15.8 per 100 000 (p<0.001) for AI/AN women and 4.6 to 25.6 per 100 000 (p<0.001) for AI/AN men. All opioid-related mortality rates increased significantly (p<0.001) from 5.2 to 33.9 per 100 000 AI/AN persons, 3.9 to 26.1 for women and 6.5 to 42.1 for men. AI/AN also exhibited significant increases in mortality rates due to opioids and alcohol, opioids and benzodiazepines, opioids and methamphetamine, and AI/AN men experienced substantial increases in mortality due to opioids and cocaine. Mortality rates by individual opioid types increased significantly over time for heroin, natural and semi-synthetic (prescription), and synthetic opioids (fentanyl/fentanyl analogues) other than methadone.ConclusionsThese findings highlight magnification over time in opioid-related deaths and may point to broader systemic factors that may disproportionately affect members of AI/AN communities and drive inequities.
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Bonk, Rachel, Ross J. Miller, Joshua Lanter, Cheryl Niblo, Jesse Kemp, and Jeremy Shelton. "Accidental Overdose Deaths in Oklahoma, 2002–2017: Opioid and Methamphetamine Trends." Journal of Analytical Toxicology 44, no. 7 (2020): 672–78. http://dx.doi.org/10.1093/jat/bkaa068.

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Abstract To evaluate trends related to accidental overdose deaths in Oklahoma, with a focus on opioids and methamphetamine. All accidental drug overdose deaths in the state of Oklahoma from 2002 to 2017 were reviewed. Opioids were grouped into the following categories: all opioids, prescription opioids, synthetic opioids and heroin. Age-adjusted death rates for methamphetamine and each opioid category were calculated and analyzed. Accidental overdoses accounted for 9,936 deaths during the study period. Of these, opioids were seen in 62.9%, with prescription opioids comprising 53.8%, synthetic opioids 10.3% and heroin 2.8%. Synthetic opioids, despite a recent upward nationwide trend, showed a slight overall decrease (−6.8%) from 2009 to 2017. In contrast, methamphetamine showed a 402.2% increase from 2009 to 2017 and an overall increase of 1,526.7%. Methamphetamine was involved in the most overdoses (1,963), followed by oxycodone (1,724). Opioid-related deaths were most common among white individuals (90.3%) and showed a slight male predilection (56.9%). With the intent of assessing the opioid epidemic as it relates to accidental overdoses in Oklahoma, this study suggests that opioid-related overdoses have slowed in recent years amidst a sharp increase in methamphetamine deaths.
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Dissertations / Theses on the topic "Opioids"

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Sawyer, Molly K. "Generation Opioid: Teacher Perspectives of Students Affected by Opioids." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1588195607758498.

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Fundytus, Marian Elaine. "Central nervous system and peripheral signs of opioid abstinence." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56639.

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It was hypothesized that a metabolite of morphine, morphine-3-glucuronide (M3G), contributes to the expression of symptoms seen during withdrawal from morphine. To test this hypothesis, the behaviors observed during precipitated withdrawal from morphine and sufentanil were compared. Sufentanil was chosen because, like morphine, it acts primarily at the mu opioid receptor, but has different metabolites. Differences in the abstinence syndromes produced by the two drugs may therefore be attributable to the actions of metabolites, rather than the primary opioid actions of morphine and sufentanil. Although there were some differences in the occurrence of symptoms, morphine and sufentanil withdrawal were very similar. Therefore, the evidence was inconclusive as to the contribution of metabolites during withdrawal.<br>Systemic administration of M3G alone and in combination with morphine produced no withdrawal-like behaviors. However, when these drugs were given centrally, withdrawal-like behaviors were observed in conjunction with seizures. The seizures were not attenuated by naloxone (but were alleviated by an anti-convulsant), indicating that they were not mediated by opioid receptors. The behaviors resembled those seen by previous investigators following high doses of morphine. The results suggest that M3G may play a role in the toxic effects of high doses of morphine.
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Raehal, Kirsten M. "Opioid-induced side effects in beta-arrestin2 and G protein-coupled receptor kinase knockout mice." Columbus, Ohio : Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1236884585.

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Seeberg, Jaclin Dee. "Opioids: Implementation of Opioid Prescribing Education and Policy in a Primary Care Center." Diss., North Dakota State University, 2020. https://hdl.handle.net/10365/31759.

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Many healthcare providers report not feeling confident when prescribing opioids, which represents an educational gap in the clinical setting that must be addressed to improve patient care and outcomes (Dowell, Haegerich, & Chou, 2016b). Healthcare providers attribute this lack of confidence in opioid prescribing to insufficient training on the tools provided to them to ensure safe prescribing habits. Thus, healthcare providers do not feel confident in managing patients’ chronic pain. A healthcare provider’s time spent with their patient is limited and therefore, needs to be utilized efficiently. In order to achieve effective time management, healthcare providers need to be experts on chronic pain management and self-assured with their practice in relation to opioids. This practice improvement project focused on increasing healthcare providers’ knowledge and confidence when prescribing opioids for chronic pain and managing chronic pain. An educational intervention with health professionals working in federally qualified health centers in North Dakota was implemented via Skype. The intervention allowed healthcare providers to be up-to-date on the most recent evidence-based literature and guidelines regarding this topic. Throughout this practice improvement project, healthcare providers were educated on the latest Centers for Disease Control (CDC) and Prevention Guideline for Prescribing Opioids for Chronic Pain, provided resources for their clinical practice, and given an opportunity to evaluate their own knowledge and confidence. The implementation of the practice improvement project was comprised of an educational session. To assess the participants’ knowledge, a pre-test was provided prior to the educational session and a post-test was given following the educational session. Furthermore, a self-confidence evaluation survey was administered, which utilized a Likert scale. Lastly, the clinic’s policies and pain agreements related to pain and opioids were reviewed and discussed. The results of the project indicated an overall increase in the participants’ knowledge and self-confidence. In addition, the project promoted awareness of the clinic’s current pain agreement and the likelihood of a future implementation of a policy regarding chronic pain management. The educational session was beneficial in promoting the use of evidence-based research and guidelines in the primary care setting.
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Odunayo, Adesola DeClue Amy. "Immunomodulatory effects of opioids." Diss., Columbia, Mo. : University of Missouri-Columbia, 2010. http://hdl.handle.net/10355/.

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The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on July 13, 2010). Thesis advisor: Amy DeClue. "May 2010" Includes bibliographical references.
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Nandi, L. Reema S. N. "The developmental neurobiology of opioids." Thesis, University College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413159.

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Österlund, Modalen Åsa. "Opioids and regulation of breathing /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-123-7/.

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Striefel, Kelsey Leigh. "Opioids: A Reason for Concern." Diss., North Dakota State University, 2018. https://hdl.handle.net/10365/27894.

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The opioid epidemic has drawn increasing attention as opioid prescribing rates and opioid related deaths continue to rise. Opioid prescribing by health care providers has quadrupled over the past 18 years and is directly proportionate to opioid-related overdoses. Primary care providers initiate chronic opioid pain management and frequently fail due to the multifaceted nature of chronic pain. A rural North Dakota health care system implemented strategies to improve chronic opioid pain management. Strategies were based on the 2016 Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain. Interventions were directed at improving opioid prescribing practices for chronic non-cancer pain management of primary care providers and reducing risks of long term opioid use. Providing clinicians with education and a quick-reference sheet on current evidence-based recommendations and accepted best practices developed their knowledge to complete remaining interventions. Chart audits identified patients on chronic opioid therapy, patients with a signed pain contract, and those with daily opioid doses meeting or exceeding recommended upper daily morphine milligram equivalence. Provider notification of identified patients allowed for further recommended interventions. Chart flagging allowed providers to easily identify patients currently on a pain contract, patients eligible for a pain contract, and patients receiving the upper daily morphine milligram equivalence limits. Evaluation was performed four months after initiation of the project. Results showed the education provided increased clinicians? knowledge and comfort in the evidence-based guidelines for managing chronic pain with opioids. Recommended monitoring strategies were improved after providers received education. Evaluation found the prescription drug monitoring program review and documentation had improved from 0 to 18. Annual urine drug screens increased from 9 to 15. Eighty-five percent of pain contract eligible patients were enrolled in a pain contract. Evaluation of patients prescribed daily morphine milligram equivalence ? 50 and ? 90 that had appropriate recommended interventions were 57% and 50% respectively. Forty-five pain management patients were identified at the time of evaluation and flagged in the electronic health record. Overall, each intervention implemented showed improvement upon comparison of pre-implementation and post-implementation data.
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Munro, Gordon. "Oxytocin neurone adaptations to opioids." Thesis, University of Edinburgh, 1994. http://hdl.handle.net/1842/21439.

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Systemic administration of sulphated cholecystokinin octapeptide (CCK8S) activates central noradrenergic pathways (including possibly the A6 cell group of the locus coeruleus which projects to the SON) and this stimulus to oxytocin secretion into the blood measured by radioimmunoassay was dose-dependently inhibited by the α<SUB>2</SUB>-adrenergic agonist clonidine and by morphine; α<SUB>2</SUB>- and μ-receptor mediated effects may converge on the same post-receptor mechanism. Cells of the locus coeruleus also show tolerance and dependence to opioids. Withdrawal hypersecretion of oxytocin was significantly attenuated by clonidine, possibly by pre-synaptically blocking the noradrenergic input from the A6 cell group although activation of this pathway by CCK8S alone did not initiate withdrawal. Thus withdrawal excitation of supraoptic oxytocin neurones may involve an excitatory noradrenergic input from the A6 cell group which may become more active during dependence. Tolerance to opioids on excitatory inputs to the SON and within the SON itself may increase the expression of several components excitatory to oxytocin neurones such as endogenous CCK function. An amplification in release of noradrenaline within the SON after removal of central morphine inhibition by naloxone, may then excite oxytocin neurones directly by increasing a voltage dependent Ca<SUP>2+</SUP><I> </I>conductance. Co-release of oxytocin and CCK would feed back onto the oxytocin neurones and sustain the withdrawal process, whilst the increase in synaptic drive from the A6 cell group and locally within the SON would continue until release of oxytocin and CCK or a pool of readily available Ca<SUP>2+</SUP> had become depleted thereby bringing the withdrawal process to an end.
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Rutten, Mikal R. "Post treatment with the novel Deltorphin-E, a delta2 opioid receptor agonist, increases recovery and survival following severe hemorrhagic shock in behaving rats." Laramie, Wyo. : University of Wyoming, 2007. http://proquest.umi.com/pqdweb?did=1313914351&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.

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Books on the topic "Opioids"

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H, Akil, Herz Albert 1921-, and Simon Eric J, eds. Opioids. Springer-Verlag, 1993.

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Cruz, Silvia L., ed. Opioids. Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-09936-6.

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Herz, Albert, Huda Akil, and Eric J. Simon, eds. Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7.

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Herz, A. Opioids. Springer-Verlag Berlin and Heidelberg, 1992.

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Herz, Albert, Huda Akil, and Eric J. Simon, eds. Opioids II. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77540-6.

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Albert, Herz, Akil H, and Simon Eric J, eds. Opioids II. Springer Verlag, 1993.

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Herz, A. Opioids II. Springer-Verlag, 1993.

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Kerr, Patrick L., Cristian Sirbu, and John M. Gregg, eds. Endogenous Opioids. Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-45493-6.

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Freye, Enno, and Joseph Victor Levy. Opioids in Medicine. Springer Netherlands, 2008. http://dx.doi.org/10.1007/978-1-4020-5947-6.

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Chrubasik, Joachim, Sigrun Chrubasik, and Laurence Mather. Postoperative Epidural Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78320-3.

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Book chapters on the topic "Opioids"

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Sundermann, Bernd, and Corinna Maul. "Opioids: 3.2 Opioid Pepties." In Analgesics. Wiley-VCH Verlag GmbH & Co. KGaA, 2005. http://dx.doi.org/10.1002/3527605614.ch3b.

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Backonja, Misha-Miroslav. "Opioids, Clinical Opioid Tolerance." In Encyclopedia of Pain. Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-28753-4_2982.

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Simon, E. J., and T. L. Gioannini. "Opioid Receptor Multiplicity: Isolation, Purification, and Chemical Characterization of Binding Sites." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_1.

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Rothman, R. B., J. W. Holaday, and F. Porreca. "Allosteric Coupling Among Opioid Receptors: Evidence for an Opioid Receptor Complex." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_10.

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Archer, S. "Chemistry of Nonpeptide Opioids." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_11.

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Portoghese, P. S. "Selective Nonpeptide Opioid Antagonists." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_12.

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Spector, S., and J. Donnerer. "Presence of Endogenous Opiate Alkaloids in Mammalian Tissues." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_13.

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Höllt, V. "Regulation of Opioid Peptide Gene Expression." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_14.

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Roberts, J. L., N. Levin, D. Lorang, J. R. Lundblad, S. Dermer, and M. Blum. "Regulation of Pituitary Proopiomelanocortin Gene Expression." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_15.

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Kley, N., and J. P. Loeffler. "Molecular Mechanisms in Proenkephalin Gene Regulation." In Opioids. Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-77460-7_16.

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Conference papers on the topic "Opioids"

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Choudhary, Ashok, Cornelius A. Thiels, and Hojjat Salehinejad. "Graph Representation of Postoperative Patients for Opioids Refill Prediction: A Real-World Case Study." In 2024 46th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). IEEE, 2024. https://doi.org/10.1109/embc53108.2024.10781606.

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Patel, Neel B., and James F. Baird. "Opioid Prescription Rates Before and After ALTO Program and Various Factors Affecting Emergency Department Opioid Prescription Rates." In 28th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2024. http://dx.doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.95_2024.

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Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, and low back pain preintervention and postintervention of ALTO at Woodbury Inspira Emergency Department in order to see the effects of ALTO. Here we report that although overall prescription rates were not significantly changed pre and post intervention, ALTO was effective in significantly reducing opioid prescriptions for migraines. In addition, female patients were significantly prescribed more opioids than male patients and young adults to adults were significantly prescribed more opioids than children, adolescent and elderly. ALTO has shown glimpses in its effectiveness in helping to reduce opioid prescription rates for specific diagnosis. More research still must be done to better understand opioid prescription rates and effectives of ALTO.
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Alapatt, Catherine, and Kinjal Shah. "The Efficacy of Osteopathic Manipulative Treatment in Reducing Pain Medication Usage in Chronic Pain Patients: A Brief Literature Review." In 27th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2023. https://doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.69_2023.

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Chronic pain is one of the most common complaints for adult patients. Chronic pain almost always includes a pharmacological approach which can involve opioids and non opioids. Non-pharmacological approaches are less commonly used by patients with chronic pain, despite the significant misuse of opioids in the treatment of chronic pain. There is a need for nonpharmacological therapies in the treatment of chronic pain patients to lessen the misuse of opioids. One underused form of nonpharmacological therapy for chronic pain is OMT. There have been several studies demonstrating OMT to be effective in treating chronic pain conditions. In addition, there is an assortment of studies demonstrating how OMT has been effective in reducing the amount of non-opioid medications patients take. However, there is a lack of information in the field detailing if OMT can decrease the amount of opioids a patient with chronic pain may take.
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Bradley, Ashley M., Angela M. Melville, Kai-For Mo, et al. "Keeping Pace with Field Detection Challenges for Synthetic Opioids." In Applied Industrial Spectroscopy. Optica Publishing Group, 2022. http://dx.doi.org/10.1364/ais.2022.atu5g.1.

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With the opioid epidemic at an all-time high, new synthetic opioids continue to emerge. To assist first responders in identifying new chemical variants, PNNL is working to expand spectral libraries of field-portable chemical detection instruments.
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de Lacerda, Dhiego Alves, Pedro Fechine Honorato, Larissa Luana Lopes Lima, et al. "Comparative review: Efficacy of opioid versus non-opioid analgesic treatment in patients with acute pain in the emergency room." In VI Seven International Multidisciplinary Congress. Seven Congress, 2024. http://dx.doi.org/10.56238/sevenvimulti2024-109.

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Acute pain, a prevalent symptom in emergency contexts, often stems from trauma, surgical interventions, or acute medical conditions, requiring effective management to mitigate discomfort and prevent chronic sequelae. This study compares the efficacy, safety, and outcomes of opioid analgesic use compared to non-opioid analgesics in acute pain management in emergency settings. The systematic review includes data from databases such as SciELO and PubMed, as well as the critical analysis of reference works in pharmacology such as "Rang &amp; Dale's Pharmacology", "Goodman &amp; Gilman's: The Pharmacological Basis of Therapeutics" and "Lange's Basic &amp; Clinical Pharmacology". The results show that while opioids offer immediate and potent relief from severe pain, non-opioids are often preferred due to a more benign safety profile.
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Elrefahy, Ahmad H. "Effects of Dexmedetomidine as an Adjunct to General Anesthesia on Postoperative Pain and Opioid Consumption in Major Abdominal Surgery." In 28th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2024. http://dx.doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.1_2024.

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This review examines the impact of dexmedetomidine, an alpha-2 adrenergic receptor agonist, on postoperative pain and opioid consumption in major abdominal surgery. Dexmedetomidine, known for its sedative, analgesic, and opioid-sparing properties, is increasingly used as an adjunct to anesthesia. Analyzing existing literature, the review found that dexmedetomidine administration alongside general anesthesia significantly improves postoperative pain management and reduces opioid consumption. Patients receiving dexmedetomidine reported decreased postoperative pain ratings and required fewer opioids during the recovery phase. Additionally, intraoperative dexmedetomidine use correlated with reduced postoperative pain severity and increased patient satisfaction compared to control groups. However, potential side effects such as bradycardia and hypotension were noted, necessitating careful patient selection and monitoring to mitigate risks. In conclusion, dexmedetomidine offers promising outcomes as an adjuvant for major abdominal surgery by providing effective analgesia while reducing reliance on opioids. Further research is warranted to optimize dosing and administration strategies, ensuring the safe and efficacious use of dexmedetomidine in perioperative care.
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Antunes, Maria da Conceição, Délio Guerra Drummond Júnior, Ariane Simião Garcia, Lethícia Mariah Marchi Bertin, and Igor Costa Santos. "Pain management in the postoperative period of invasive surgery." In III SEVEN INTERNATIONAL MULTIDISCIPLINARY CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/seveniiimulti2023-105.

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Introduction: Adequate pain management in the postoperative period of invasive surgeries is essential to promote patients' recovery and improve their quality of life. Postoperative pain can be severe and compromise respiratory function and overall well-being. Therefore, effective pain management strategies are essential. Objective: To examine the management of pain in the postoperative period of invasive surgery, exploring the available therapeutic options, their indications and clinical outcomes. Theoretical Framework: The topics covered include the different pharmacological approaches in 5 axes: such as the use of opioid and non-opioid analgesics, regional block techniques, adjuvant therapies such as acupuncture and hypnosis, as well as multimodal pain control strategies. Methodology: The electronic databases PubMed, Scopus and Web of Science were used. The following English descriptors were used: "postoperative pain management", "invasive surgery", "pain control strategies". The inclusion criteria were articles available in full text and written in English published in the last 10 years. Final Results: Pain management in the postoperative period of invasive surgery requires an individualized and multimodal approach. In addition to opioids, non-opioid analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), play an important role in the management of mild to moderate pain and can be used alone or in combination with opioids. Regional block techniques, such as peripheral nerve block and epidural block, have also been shown to be effective in reducing postoperative pain and decreasing the need for systemic opioids. Adjuvant therapies, such as acupuncture and hypnosis, and multimodal strategies, which combine different therapeutic approaches, have gained prominence as complementary options for pain management, helping to reduce the use of medications and promoting patient well-being.
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Rahman, M. Shafiqur, and Uttam K. Chakravarty. "Characterizations of Diagnostic Properties and Detection Techniques of Fentanyl and Related Synthetic Opioids." In ASME 2018 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/imece2018-87803.

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Fentanyl, a synthetic opioid, is an extremely fast-acting synthetic narcotic analgesic having a high potency of approximately 100 to 200 times that of Morphine. As the synthetic opioid crisis continues to sweep across the world, detection technologies are required to be enhanced to detect, categorize, and identify synthetic opioids effectively. To detect fentanyl and its analogues, immunoassay screens are commercially available for urine specimens. Simple colorimetric assays, i.e., spot tests with paper strips, offer speed, simplicity of operation, portability, and affordability. The microfluidic behavior of the paper strips along with the properties of chemical reagents play significant role in drug detection methods. Therefore, the objectives of this study are to characterize the chemical properties of fentanyl and its analogues and to conduct microfluidic analysis for design optimization and performance evaluation of the fentanyl test strips. A computational fluid dynamics model is developed to evaluate the microfluidic properties. Analytical study and Experiments with test-kit samples are also conducted to validate the results of the numerical simulation. Finally, the performance parameters based on microfluidic analysis were reported showing the room for improvements in the detection technology of fentanyl and related synthetic opioids.
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"METHADONE WITHDRAWAL PSYCHOSIS: A CLINICAL CASE." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p132v.

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The purpose of this article is, through a clinical case, to review the literature on psychosis secondary to methadone withdrawal. Observation of the patient and consultation of the clinical file. Non-systematic literature review on methadone use, methadone discontinuation and dual pathology. A 47-year-old male, history of opioid and cannabinoid use disorder, currently in abstinence and under opioid substitution therapy with methadone. After abrupt discontinuation of methadone, he began presenting delusional ideas of jealousy and persecution with multiple delusional interpretations. A diagnosis of persistent delusional disorder was made, and he was medicated with long-term injectable aripiprazole. Methadone is a synthetic opioid agonist used to treat addictions to opioids, such as heroin. Methadone maintenance treatment (MMT) contributes to cessation or reduction of heroin use, reduced risk of HIV and hepatitis virus infections, decreased mortality, improved family and social relationships and employment status. Side effects include dizziness, drowsiness, vomiting, sweating, respiratory depression and prolongation of the QT interval. Other important consequences are precipitation of withdrawal symptoms with consequent relapse to heroin use and withdrawal from MMT. Methadone withdrawal leads to the classic symptoms of opiate withdrawal - abnormalities in vital signs, dilated pupils, agitation, irritability, insomnia, sneezing, nausea and vomiting. In a minority of cases, it can lead to the sudden onset of affective disorders and psychotic disorders. Although scarce, psychotic symptoms after opioid withdrawal have already been described in the literature. Opioids function not only as neurotransmitters, but also as neuromodulators that may be involved in the regulation of the dopaminergic system. An altered neuromodulation of the central opioid-dopamine systems due to long-term MTM may be related to psychotic pathogenesis. Considering the high prevalence of psychiatric comorbidity in patients with substance use disorder, it's important to pay attention and monitor any change in opioid medication, with close observation for possible psychotic symptoms.
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Lopez-Quintero, Catalina, Alyssa Falise, James Cury, et al. "Medical Cannabis Use Among Adults Who Report Non-Medical Use of Prescription Opioids for Pain Relief." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.23.

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Objectives: This study uses a nationally representative sample of adults to investigate racial-ethnic differences in reasons for cannabis use among those reporting past 12-month misuse of prescription opioids for pain relief. Methods: Data from the 2015-2019 National Surveys on Drug Use and Health were used to study 3,093 adults 18 to 49 years old reporting past 12-month pain-related prescription pain reliever (opioid) misuse. Logistic regressions assessed the association between past 12-month cannabis use – (non medical vs. any medical) – and multiple socio-demographic, psycho-social and drug use correlates. NSDUH analysis weights were applied to accommodate for the sampling design. Results: Half of individuals who reported misuse of prescription opioids for pain relief used cannabis in the past 12-months. In this sample of cannabis users, 87.6% (95%CI = 86.1, 88.9) used non-medically, and 12.4 (95%CI = 11.1, 13.9) used for both medical and recreational reasons. Individuals with past 12 months diagnosis of opioid use disorder were 1.8 (95%CI = 1.29, 2.63) times as likely to be medical cannabis users compared to those without a disorder. Conclusions: The findings indicate that medical cannabis might be an alternative for nearly one in eight individuals misusing pain relievers to alleviate their pain, primarily those with an opioid use disorder. Despite increased rates of cannabis use among males and non-Hispanic Whites in the general population, no gender or racial-ethnic differences were found in the selected sample. Future studies should investigate simultaneous use and the analgesic effects of co-use in this sample.
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Reports on the topic "Opioids"

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St. John, Haley, and Juliette Scantlebury. A 10-Year Review of Opioid-Related Deaths at West Tennessee Regional Forensic Center: 2007-2017. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/com.lsp.2019.0005.

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Prescription opioid deaths have tripled since 1999, and currently opioid overdose kills 115 Americans per day on average (1). Prior to 2014, prescription opioids have been the primary driver of opioid-related mortality. In recent years, the United States has seen a steady decline in the rate of opioid prescription. At the same time, there has been a significant increase in the number of deaths attributed to non-prescription opioids such as heroin, illicitly manufactured fentanyl, and fentanyl analogues. In 2017, among 70,237 drug overdose deaths nationally, 47,600 (67.8%) involved opioids, with increases across age groups, racial/ethnic groups, and county urbanization levels in multiple states (2). The opioid epidemic is especially profound in Tennessee, which had the 3rd highest opioid prescription rate in the country in 2017 and an opioid-related death rate of 19.3 deaths per 100,000 persons, compared to the national average of 14.6 (3). This retrospective study analyzes autopsy data from West Tennessee Regional Forensic Center (WTRFC) from 2007 to 2017 to gain a better understanding of the effects of the opioid epidemic on West Tennessee and the surrounding areas. Data from opioid-related accidents and suicides were analyzed in order to identify trends in race, age, gender, location, types of opioids, and drug combinations involved in opioid-related deaths.
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Greenwood, Jeremy, Nezih Guner, and Karen Kopecky. The Downward Spiral: A Macroeconomic Analysis of the Opioid Crisis. Federal Reserve Bank of Cleveland, 2024. http://dx.doi.org/10.26509/frbc-wp-202418.

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There have been more than 700,000 opioid overdose deaths since 2000. To analyze the opioid epidemic, a model is constructed where individuals choose whether to use opioids recreationally, knowing the probabilities of addiction and dying. These odds are functions of recreational opioid usage. The model is fit to estimated Markov chains from the US data that summarize the transitions into and out of opioid addiction as well as to a deadly overdose. The epidemic is broken down into two subperiods: 2000-2010 and 2010–2019. The opioid epidemic's drivers, their impact on employment, and the impact of medical interventions are examined. Lax prescribing practices and misinformation about the risk of addiction are important drivers of the first half of the epidemic. Falling prices for black-market opioids combined with an increase in their lethality are found to be important for the second half.
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Adamopoulou, Effrosyni, Jeremy Greenwood, Nezih Guner, and Karen Kopecky. The role of friends in the opioid epidemic. Federal Reserve Bank of Cleveland, 2024. http://dx.doi.org/10.26509/frbc-wp-202404.

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The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of someone misusing opioids on the probability that their best friends also misuse. The estimated peer effects are significant: Having a best friend with a reported serious injury in the previous year increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is driven by individuals without a college degree and those who live in the same county as their best friends.
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Callaghan, Timothy H., Kristin Primm, Marvellous Akinlotan, et al. The Co-occurrence of HIV and Opioid Mortality in Rural and Urban America from 1999-2018. Southwest Rural Health Research Center, Texas A&M School of Public Health, 2021. http://dx.doi.org/10.21423/1969.1/201251.

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Previous research has noted that the U.S. is facing dual public health crises associated with opioid use disorder (OUD) and human immunodeficiency virus (HIV). Fatalities associated with OUD have been reported with increasing frequency, and researchers have posited that the injection of opioids could have implications for HIV rates and mortality. The current body of literature outlining connections between HIV and OUD does not account for differences in rural and urban areas. Using the Centers for Disease Control and Prevention Wide-ranging Online Date for Epidemiology Research mortality database, this brief finds no positive relationship between opioid mortality and HIV mortality over time. Instead, the results show a consistent decline in HIV mortality rates and a troubling rise in deaths from opioids across the time period analyzed.
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Gomes, Tara, David Juurlink, Rahim Moineddin, et al. Prescribing of opioids and opioid-related mortality in Ontario: 2004 - 2006. ODPRN, 2012. http://dx.doi.org/10.31027/odprn.2012.01.

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Zullo, Andrew R., Kristin J. Danko, Patience Moyo, et al. Prevention, Diagnosis, and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults. Agency for Healthcare Research and Quality (AHRQ), 2020. http://dx.doi.org/10.23970/ahrqepctb37.

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Ziedan, Engy, and Robert Kaestner. Effect of Prescription Opioids and Prescription Opioid Control Policies on Infant Health. National Bureau of Economic Research, 2020. http://dx.doi.org/10.3386/w26749.

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Chou, Roger, Jesse Wagner, Azrah Y. Ahmed, et al. Treatments for Acute Pain: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), 2020. http://dx.doi.org/10.23970/ahrqepccer240.

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Objectives. To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) to August 2020, reference lists, and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) of outpatient therapies for eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain following discharge, dental pain (surgical or nonsurgical), pain due to kidney stones, and pain due to sickle cell disease. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain, and likelihood of repeat or rescue medication use and adverse events. The magnitude of effects was classified as small, moderate, or large using previously defined criteria, and strength of evidence was assessed. Results. One hundred eighty-three RCTs on the comparative effectiveness of therapies for acute pain were included. Opioid therapy was probably less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) for surgical dental pain and kidney stones, and might be similarly effective as NSAIDs for low back pain. Opioids and NSAIDs were more effective than acetaminophen for surgical dental pain, but opioids were less effective than acetaminophen for kidney stone pain. For postoperative pain, opioids were associated with increased likelihood of repeat or rescue analgesic use, but effects on pain intensity were inconsistent. Being prescribed an opioid for acute low back pain or postoperative pain was associated with increased likelihood of use of opioids at long-term followup versus not being prescribed, based on observational studies. Heat therapy was probably effective for acute low back pain, spinal manipulation might be effective for acute back pain with radiculopathy, acupressure might be effective for acute musculoskeletal pain, an opioid might be effective for acute neuropathic pain, massage might be effective for some types of postoperative pain, and a cervical collar or exercise might be effective for acute neck pain with radiculopathy. Most studies had methodological limitations. Effect sizes were primarily small to moderate for pain, the most commonly evaluated outcome. Opioids were associated with increased risk of short-term adverse events versus NSAIDs or acetaminophen, including any adverse event, nausea, dizziness, and somnolence. Serious adverse events were uncommon for all interventions, but studies were not designed to assess risk of overdose, opioid use disorder, or long-term harms. Evidence on how benefits or harms varied in subgroups was lacking. Conclusions. Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events. Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions. Research is needed to determine the comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge; effects of therapies for acute pain on non-pain outcomes; effects of therapies on long-term outcomes, including long-term opioid use; and how benefits and harms of therapies vary in subgroups.
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Hughes, Lauren M., Michael G. Irwin, and Claire C. Nestor. Adjuvant medications for use with propofol-based total intravenous anaesthesia. World Federation of Societies of Anaesthesiologists, 2024. http://dx.doi.org/10.28923/atotw.529.

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Knowledge of the pharmacological differences between opioid and non-opioid TIVA adjuncts is essential for providing safe and effective TIVA. Whilst opioids play a large role in providing the analgesic component of TIVA, non-opioid adjuncts should also be considered. Selected concentrations of TCI infusions should be individualised to the patient, extent of surgery, and other drugs administered. It is essential to calibrate the TCI to the patient’s response at all times. These basic principles reiterate the recommendations from the international guidelines for TIVA administration ​(31)​, and remain true regardless of the different agents used.
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Acred, Aleksander, Milena Devineni, and Lindsey Blake. Opioid Free Anesthesia to Prevent Post Operative Nausea/Vomiting. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/con.dnp.2021.0006.

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Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice. Methods In this scoping review, the MeSH search terms used to collect data were “anesthesia”, “postoperative nausea and vomiting”, “morbidity”, “retrospective studies”, “anesthesia, general”, “analgesics, opioid”, “pain postoperative”, “pain management” and “anesthesia, intravenous”. The Discovery Search engine, AccessMedicine and UpToDate were the search engines used to research this data. Filters were applied to these searches to ensure all the literature was peer-reviewed, full-text and preferably from academic journals. Results Opioid free anesthesia was found to decrease PONV by 69%. PONV incidence was overwhelming decreased with opioid free anesthesia in every study that was reviewed. Implications The future direction of opioid-free anesthesia and PONV prevention are broad topics to discuss, due to the nature of anesthesia. Administration of TIVA, esmolol and ketamine, as well as the decision to withhold opioids, are solely up to the anesthesia provider’s discretion. Increasing research and education in the importance of opioid-free anesthesia to decrease the incidence of PONV will be necessary to ensure anesthesia providers choose this protocol in their practice.
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