Risk of Opioid Use Disorder from Exposure to Opioids in the Perioperative Period: A Systematic Review

Malik, Khalid; Imani, Farnad; Beckerly, Rena; Chovatiya, Rani

doi:10.5812/aapm.101339

Cited by 48 publications

(47 citation statements)

References 26 publications

(112 reference statements)

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“…A larger surgical field allows for fewer iatrogenic injuries; however, it involves an incision and scar. Additionally, some complications have been recorded, and the risk of opioid use disorder in surgical patients is of some concern (6) Endoscopic techniques are less invasive and are proved to reduce post-operative recovery time. They have a high success rate and are desirable by their reduction in postoperative recovery time and smaller incisions than open techniques (31).…”

Section: Surgical Techniquesmentioning

confidence: 99%

Etiology Diagnosis and Management of Radial Nerve Entrapment

et al. 2021

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Context: The anatomy of the radial nerve is prone to entrapment, each with different symptomology. Compression of entrapment of the radial nerve can occur near the radiocapitellar joint, the spiral groove, the arcade of Frohse, the tendon of the extensor carpi radialis brevis (ECRB), and at the radial tunnel. Those who require repetitive motions are at increased risk of peripheral neuropathy syndromes, including repetitive pronation and supination, trauma, or systemic disease; however, t the influence of all risk factors is not well understood. Depending on the location of entrapment, radial nerve entrapment syndrome presents different symptoms. It may include both a motor component and a sensory component. The motor component includes a dropped arm, and the sensory component can include pain and paresthesia in the distribution of the radial nerve that resolves with rest and exacerbates by repetitive pronation and supination. Evidence Acquisition: Diagnostic evaluation for radial nerve entrapment, apart from clinical symptoms and physical exam, includes electromyography, nerve conduction studies, ultrasonography, and magnetic resonance imaging. Conservative management for radial nerve entrapment includes oral anti-inflammatory medications, activity modification, and splinting. Some recently performed studies mentioned promising minimally invasive techniques, including corticosteroid injections, peripheral nerve stimulation, and pulsed radiofrequency. Results: When minimally invasive techniques fail, open or endoscopic surgery can be performed to release the nerve Conclusions: Endoscopic surgery has the benefit of decreasing incision size and reducing time to functional recovery.

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Section: Surgical Techniquesmentioning

confidence: 99%

Etiology Diagnosis and Management of Radial Nerve Entrapment

et al. 2021

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“…The pain is not always fully relieved by such agents, and the patients can develop tolerance to them. The ever-increasing doses of opioids are not without adverse effects (6,7). Alternative approaches, which reduce the requirement for potent opioids postoperative, are required.…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Ketamine Infusion Versus Morphine Infusion During Abdominoplasty to Change the Postoperative Pain Profile

2020

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Background: With the increased number of abdominoplasty all over the world, and the need to manage postoperative pain, it is a must to find proper and effective drugs to decrease opioid consumption in the postoperative period. Objectives: In this double-blind randomized controlled clinical trial, we assumed that low-dose ketamine infusion will reduce the postoperative pain profile than the conventional method of morphine. Methods: The scheduled patients for abdominoplasty under general anesthesia were recruited in two groups: group (K) with low-dose ketamine infusion intra-operatively (80 patients) and group (M) with morphine infusion intra-operatively (80 patients). Both groups were monitored intraoperatively and postoperatively for rescue doses of fentanyl, visual analogue scale (VAS), and side effects. Results: There were no statistical differences between both groups regarding the fentanyl rescue doses intra- and postoperative with no remarkable side effects. Conclusions: Low-dose ketamine has a useful analgesic effect in abdominoplasty similar to morphine without remarkable side effects, such as sedation or hallucinations.

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“…In trying to avoid opioid use, cannabis has also been gaining recognition in the treatment of chronic pain (24). Infusion therapy may also include options such as ketamine, lidocaine, magnesium, and dexmedetomidine (25)(26)(27)(28)(29)(30), while considering possible side effects, such as toxicity, addiction, and psychosocial harm (31,32). Invasive interventions such as surgery, radiofrequency ablation, surgical, root injections, epidural injections, are not recommended unless patients have neck pain associated with structural disruption or radiculopathy (20,22,33).…”

Section: Neck Painmentioning

confidence: 99%

Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain

et al. 2021

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Context: Neck pain is a common phenomenon and affects a large segment of the population. Chronic neck pain, lasting more than 3 months, likely occurs in 10% - 30% of patients with acute neck pain and affects up to 288 million cases globally, carrying a significant cost in terms of quality of life, disability, and healthcare dollars. Here we review neck pain background, acupuncture and the evidence that exist to support acupuncture use in chronic neck pain. Results: Neck pain not only affects quality of life directly, but also contributes to depression, job dissatisfaction and reduced productivity. Unfortunately, neck pain is strongly linked to office and computer work and is likely to continue increasing in prevalence. Traditional treatments, such as analgesics, physical therapy, exercise, and non-invasive therapy bring some relief, and invasive therapy is indicated if anatomical pathologies exist. Acupuncture is a form of integrative medicine, originally described and practiced in traditional Chinese medicine and now expanded to include methods including acupressure, dry needling, and others. Traditionally, it focused on restoring the patient’s flow of Qi by puncturing specific points along the meridians. It has previously been shown to be effective in other forms of chronic pain and disability. Clinical trials studying acupuncture for neck pain have shown significant reduction in both pain and associated symptoms. These therapies are reviewed in this text. Conclusions: Neck pain is a common and significant global problem. Acupuncture, dry needling, and cupping were all shown to be effective in alleviating pain both immediately after treatment, as well as provide long-lasting relief. These treatments are generally safe and inexpensive and should be considered as part of a multimodal approach for the treatment of neck pain. More head-to-head studies will provide better data to support a choice of a specific treatment over another.

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Risk of Opioid Use Disorder from Exposure to Opioids in the Perioperative Period: A Systematic Review

Cited by 48 publications

References 26 publications

Etiology Diagnosis and Management of Radial Nerve Entrapment

Etiology Diagnosis and Management of Radial Nerve Entrapment

Low-Dose Ketamine Infusion Versus Morphine Infusion During Abdominoplasty to Change the Postoperative Pain Profile

Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain

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