BACKGROUND Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid uti...

OBJECTIVE To assess clinical efficacy of controlled-release oxycodone (CRO) 20 mg on a 12-h dosing schedule in this prospective, randomised, placebo-controlled, double-blinded study of 40 ASA physical status I-III women undergoing breast surgery for cancer. RESEARCH DESIGN AND METHODS General anaesthesia using remifentanil and propofol was performed for surgery. Both groups received premedica...

In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient-controlled analgesia (PCA) for postoperative pain in order to clarify this controversy. Our primary aim w...

BACKGROUND AND OBJECTIVES Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative t...

Opioids have long been known to have an important role in feeding behavior, particularly related to the rewarding aspects of food. Considerable behavioral evidence suggests that sucrose consumption induces endogenous opioid release, affecting feeding behavior as well as other opioid-mediated behaviors, such as analgesia, dependence, and withdrawal. In the present study, rats were given access t...

Numerous neurotransmitter systems [e.g. dopamine, gamma-aminobutyric acid (GABA), the endogenous opioids, and serotonin (5-hydroxytryptamine, 5-HT)] are involved in the regulation of alcohol consumption. Because 5-HT reuptake inhibitors and opioid antagonists modify the activity of neurotransmitters, it has been hypothesized that they may also mediate the desire to drink alcohol by acting on sp...

Background The anti-inflammatory effects of statins have been suggested to relieve postoperative pain. This retrospective study tested the association between the perioperative routine use of statins in therapeutic doses, and opioid requirements and pain scores, after hip replacement surgery. Methods With IRB approval, data was obtained for adult patients who had elective hip replacement surg...

BACKGROUND Gabapentin and pregabalin have antiallodynic and antihyperalgesic properties useful for treating neuropathic pain. These properties may also be beneficial in acute postoperative pain. In this study we evaluated randomized, controlled trials examining the analgesic efficacy, adverse effects, and clinical value of gabapentinoids in postoperative pain. METHODS A systematic search of M...

Methods: We performed a prospective, randomized cohort study of women ≥ 18 years desiring elective breast augmentation surgery. The study includes a non-randomized cohort of patients who chose to have standard evaluation and 3D simulation. IRB approval was obtained through Washington University in St. Louis/Barnes-Jewish Hospital. Our intended analysis is for 100 patients to be recruited into t...

BACKGROUND Opioids are considered a cornerstone in the treatment of cancer pain. OBJECTIVES To assess opioid use during a 6 year period (2001-2006) among cancer patients served by Clalit Health Services, the largest health management organization in Israel. METHODS Purchasing data of opioids authorized for use in Israel were obtained from the computerized databases of Clalit for the period ...