Recently, the outcomes were published of the Global Opioid Policy Initiative, evaluating the availability, cost of opioid medicines and the regulatory barriers that are possibly impeding access for the management of cancer pain in developing countries. Other studies have shown that the vast majority of the world population has no access to opioid analgesics. This study shows by country which op...

Alcoholism is a chronic relapsing disorder characterized by continued alcohol use despite numerous adverse consequences. Alcohol has been shown to interact with numerous neurotransmitter systems to exert its pharmacological effects. The endogenous opioid system (EOS) has been strongly implicated in the positive and negative reinforcing effects of alcohol. Traditionally recognized as dysphoric/a...

BACKGROUND Rats with liver cirrhosis, evoked by chronic administration of thioacetamide (TAA), consumed voluntarily more alcohol than their healthy counterparts. Seeking the mechanisms underlying this phenomenon, the opioid system was screened for involvement and alterations. In vivo, the influence of chronically administered Naloxone and Naltrexone, non-specific opioid receptor antagonists, on...

Asia is a heterogeneous region with substantial variability in economic, social and palliative care development. While the global consumption of opioids has increased, the consumption in most Asian countries has not increased at the same rate. This is the first comprehensive study of opioid availability and accessibility for cancer patients in Asia. Data are reported on the availability and acc...

Animal studies have demonstrated that alcohol changes neurotransrrutter concentrations in the brain. These changes in levels of dopamine, serotonin, ^aminobutync acid (GABA), endogenous opioid peptides, and noradrcnaline are associated with activation of reward centres in the brain. It is this property of alcohol that is believed to be responsible for the reinforcing effect of alcohol consumpti...

Total knee arthroplasty (TKA) is associated with considerable postoperative pain. The relative analgesic efficacy and adverse effect profile of perioperative use of selective cyclooxygenase-2 (COX-2) inhibitors for patients undergoing TKA are unclear. This is a systematic review and meta-analysis of all randomized controlled trials evaluating perioperative administration of COX-2 inhibitors for...

Background:Naltrexone is a competitive opioid receptor antagonist blocking the euphoric effects of exogenous opioids. When used concomitantly with opioids, naltrexone causes severe withdrawal symptoms.The main aim of the study is to determine the symptomatology and outcome of patients who consumed naltrexone in conjunction with an opioid substance. Methods:This cross-sectional study was perf...

BACKGROUND The majority of surgical patients experience significant levels of pain after a procedure. While opioid analgesics have been a mainstay of postsurgical analgesic regimens, recent evidence has supported the use of multimodal therapy as a way to decrease opioid usage with its concomitant opioid-related adverse events. The goal of multimodal therapy is to minimize the negative effects o...

BACKGROUND The transversus abdominis plane (TAP) block has been shown to provide effective postoperative analgesia in lower abdominal surgery. Subcostal TAP block has also been proposed as a new technique to provide analgesia for the supraumbilical abdomen. We compared the analgesic and opioid-sparing effects of a single-injection subcostal TAP block with continuous thoracic epidural analgesia ...

Esmolol has been shown to improve postoperative pain and reduce opioid requirements. The aim of this systematic review was to evaluate the effect of perioperative esmolol as an adjunct on early postoperative pain intensity, recovery profile, and anesthetic requirement. Databases were searched for randomized placebo-controlled trials evaluating the effects of esmolol during general anesthesia. P...