Opioid Conversions in Acute Care

Patanwala, Asad E.; Duby, Jeremiah J.; Waters, Dustin; Erstad, Brian L.

doi:10.1345/aph.1h421

Cited by 207 publications

(129 citation statements)

References 58 publications

(7 reference statements)

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“…This has been reflected in other studies [15] that have measured the pattern of opioid use in the 24 h after UAE, and also in our study where mean PCA opioid across both groups was much less in the 6 to 24 h period (6.28 mg) compared to the 0 to 6 h period (14.9 mg). We also provided an oral dose of oxycodone which should have provided a peak concentration at approximately 3.2 h [21,22], theoretically matching the time period of peak analgesic requirement. However, this did not appear to offer any analgesic advantage.…”

Section: Discussionmentioning

confidence: 99%

“…Cumulative opioid requirement was measured with reference to the Abbot Gemstar. Opioid requirement was measured as intravenous morphine equivalent from the time of premedication until the patient ceased to require postprocedural opioid treatment after discharge, with 1 mg of oral oxycodone taken to be equivalent to 0.5 mg of intravenous morphine [22]. Patients were followed up by phone after discharge until they did not require oral opioid treatment.…”

Section: Methodsmentioning

confidence: 99%

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A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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Purpose To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease. Methods Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005). Results Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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“…We calculated the total amount of oral morphine equivalents that each patient used between midnight and midnight on the day of enrollment with the following conversion with 30 oral morphine equivalents equivalent to 10 mg intravenous morphine sulfate; 1.5 mg intravenous hydromorphone; 7.5 mg oral hydromorphone; 20 mg oral oxycodone; 30 mg oral hydrocodone; and 150 mg oral tramadol [20,30,33].…”

Section: Methodsmentioning

confidence: 99%

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Bot

Bekkers

Arnstein

et al. 2014

Clinical Orthopaedics &Amp; Related Research

155

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Background In 2012, Medicare began to tie reimbursements to inpatient complications, unplanned readmissions, and patient satisfaction, including satisfaction with pain management. Questions/purposes We aimed to identify factors that correlate with (1) pain intensity during a 24-hour period after surgery; (2) less than complete satisfaction with pain control; (3) less than complete satisfaction with staff attention to pain relief while in the hospital; and we also wished (4) to compare inpatient and discharge satisfaction scores. Methods Ninety-seven inpatients completed measures of pain intensity (numeric rating scale), satisfaction with pain relief, self-efficacy when in pain, and symptoms of depression days after operative fracture repair. The amount of opioid used in oral morphine equivalents taken during the prior 24 hours was calculated. Through initial bivariate One of the authors (AGJB) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period from ''AnnaFonds Travel grant'' (Dutch Orthopaedic travel grant), Leiden, the Netherlands (less than USD 10,000); ''VSBfonds'', Utrecht, the Netherlands, a nonmedical study grant (less than USD 10,000); and ''Prins Bernhard Cultuurfonds, Banning-de Jong fonds'', Amsterdam, the Netherlands, a nonmedical study grant (less than USD 10,000). One of the authors (SB) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than 10,000 USD from a VU University ''Faculty Fund'', Amsterdam, the Netherlands. One of the authors (PMA) has received funding from Connell Nursing Research Scholarship (less than USD 10,000); the Nurse Practitioner Healthcare Foundation (less than USD 10,000); the American Pain Society and the American Association of Nurse Practitioners (less than USD 10,000); the Nurse Practitioner Healthcare Foundation (less than USD 10,000); and F.D. Davis Publishers (less than USD 10,000). One of the authors (DR) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period from a study-specific grant from Skeletal Dynamics (USD 10,000-100,000) (Miami, FL, USA); is a consultant for Wright Medical (Memphis, TN, USA), Skeletal Dynamics, and Biomet (Warsaw, IN, USA) (less than USD 10,000); received honoraria from AO North America (Paoli, PA, USA), and AO International (less than USD 10,000); and received royalties from Wright Medical (less than USD 10,000). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. and then multivariate analysis, we identified factors that we...

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“…During the study period, dexmedetomidine was not available in the Netherlands. In the statistical analyses, benzodiazepine dosages were converted in diazepam equivalents [27] and opioid dosages into fentanyl equivalents [28].…”

Section: Medication Usementioning

confidence: 99%

Intensive care unit environment may affect the course of delirium

et al. 2012

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Purpose: Delirium is a common disorder in intensive care unit (ICU) patients. It is unclear whether ICU environment affects delirium. We investigated the influence of ICU environment on the number of days with delirium during ICU admission. Methods: In this prospective before-after study, ICU delirium was compared between a conventional ICU with wards and a single-room ICU with, among others, improved daylight exposure. We included patients admitted for more than 24 h between March and June 2009 (ICU with wards) or between June and September 2010 (single-room ICU). Patients who remained unresponsive throughout ICU admission were excluded. The presence of delirium in the preceding 24 h was assessed daily with the confusion assessment method for the ICU (CAM-ICU) by research physicians combined with evaluation of medical and nursing charts. The number of days with delirium was investigated with Poisson regression analysis. Results: We included 55 patients (449 observation days) in the ICU with wards and 75 patients (468 observation days) in the single-room ICU. After adjusting for confounding, the number of days with delirium decreased by 0.4 days (95 % confidence interval 0.1-0.7) in the singleroom ICU (p = 0.005). The incidence of delirium during ICU stay was similar in the ICU with wards (51 %) and in the single-room ICU (45 %, p = 0.53). Conclusions: This study is the first to show that ICU environment may influence the course of delirium in ICU patients.

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Opioid Conversions in Acute Care

Cited by 207 publications

References 58 publications

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Intensive care unit environment may affect the course of delirium

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