PURPOSE Use of nonopioid analgesics (including nonsteroidal anti-inflammatory drugs) for postoperative pain management can reduce opioid consumption and potentially prevent opioid-related adverse events. This study examined the postoperative opioid-sparing effect of repeated-dose injectable diclofenac formulated with hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac. PATIENTS AND METHODS Pooled...

CONTEXT In most countries, patients do not have adequate access to opioid analgesics because of barriers resulting from the abuse potential of these medicines. OBJECTIVES To provide an analysis for the adequacy of the consumption of opioid analgesics for countries and World Health Organization regions in 2010 as compared with 2006. METHODS We calculated the Adequacy of Consumption Measure u...

The development of alcohol dependence is the result of a combination of various factors. Psychosocial and psychiatric conditions, together with functional alterations of the brain or genetic traits, contribute to the development of problems related to alcohol use or alcohol dependence. Clinical studies using neuroimaging techniques (PET, fMRI) and preclinical studies using different animal mode...

Parenteral opioid use after total knee (TKA) and hip (THA) arthroplasty often results in substantial functional interference and side effects. This prospective study compared use of traditional intravenous patient-controlled analgesia (IV PCA) with a novel oral regimen after TKA and THA. Sixty-two patients received IV PCA and 62 received scheduled long-acting and, as needed, short-acting oral o...

Although far from conclusive, evidence implicating the endogenous opioid system in the development and maintenance of alcoholism is growing. Currently available data suggest that ethanol increases opioid neurotransmission and that this activation is part of the mechanism responsible for its reinforcing effects. Findings from preclinical research indicate that ethanol consumption and ethanol-ind...

It is well known that the mu-opioid receptor (MOR) plays an important role in the rewarding properties of ethanol. However, it is less clear how chronic ethanol consumption affects MOR signaling. Here, we demonstrate that rats with prolonged voluntary ethanol consumption develop antinociceptive tolerance to opioids. Signaling through the MOR is controlled at many levels, including via the proce...

Nucleus accumbens micro-opioid stimulation leads to robust increases in the intake of highly palatable foods, such as a high-fat diet. While interactions between opioids and certain striatal neurotransmitters underlying this phenomenon have been explored, many potential interactions have not. Striatal adenosine has been shown to have a significant influence on striatal neurotransmission and loc...

background: acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity . gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. the aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consu...

background: opioid drugs are the most effective drugs for the treatment of moderate to severe pain. rates of opioid use are influenced by a variety of factors. the aim of this study was to determine the pattern of use of parenteral opioid drugs in hospitalized patients in a referral teaching hospital. methods: in a retrospective study, required data were extracted from medical records of adult ...