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 Data of the Central Bureau of Statistic of Nepal from 2008 show a total of more than 46,000 illegal drug users, out of which 61% are injecting drug users (IDU). An injecting mix of medicines like opioids, benzodiazepines and antihistamines (the so-called South Asian cocktail) was prevalent. Furthermore, it is estimated that about 70,000 people are living with human immunodeficiency v...

The number of available opioid preparations, each with differing chemical properties, structure and opioid receptor affinity, increases with time. The efficacy of these opioids in the treatment of pain arising from a diverse range of disorders is beyond question. With the passage of time, the list of those conditions where an opioid is recommended as a treatment option increases, and that list ...

BACKGROUND Medical schools are grappling with how best to manage industry involvement in medical education. OBJECTIVE To describe a case study of industry-supported undergraduate medical education related to opioid analgesics. METHOD Institutional case study. RESULTS As part of their regular curriculum, Canadian medical students attended pain pharmacotherapy lectures that contained questi...

This commentary relates to the recently published essay in PLOS Medicine, entitled "Untreated Pain, Narcotics Regulation, and Global Health Ideologies." That essay describes regulatory and other systemic barriers preventing the accessibility of opioid analgesics and contributing to patients not receiving adequate pain relief. Four main points highlighted in the essay are discussed in this comme...

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...