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  1 / 1348 MEDLINE  
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[PMID]:28459910
[Au] Autor:Raub JN; Vettese TE
[Ad] Endereço:Internal Medicine, Detroit Receiving Hospital/Detroit Medical Center, Wayne State University School of Medicine, and Department of Pharmacy Services, Wayne State University, all in Detroit, MI.
[Ti] Título:Acute Pain Management in Hospitalized Adult Patients with Opioid Dependence: A Narrative Review and Guide for Clinicians.
[So] Source:J Hosp Med;12(5):375-379, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pain management is a core competency of hospital medicine, and effective acute pain management should be a goal for all hospital medicine providers. The prevalence of opioid use in the United States, both therapeutic and non-medical in origin, has dramatically increased over the past decade. Although nonopioid medications and nondrug treatments are essential components of managing all acute pain, opioids continue to be the mainstay of treatment for severe acute pain in both opioid-naïve and opioid-dependent patients. In this review, we provide an evidence-based approach to appropriate and safe use of opioid analgesics in treating acute pain in hospitalized patients who are opioid-dependent. Journal of Hospital Medicine 2017;12:375-379.
[Mh] Termos MeSH primário: Dor Aguda/terapia
Hospitalização
Transtornos Relacionados ao Uso de Opioides/terapia
Manejo da Dor/métodos
Médicos/normas
Guias de Prática Clínica como Assunto/normas
[Mh] Termos MeSH secundário: Dor Aguda/diagnóstico
Adulto
Analgésicos Opioides/efeitos adversos
Analgésicos Opioides/uso terapêutico
Seres Humanos
Transtornos Relacionados ao Uso de Opioides/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2733


  2 / 1348 MEDLINE  
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[PMID]:29369883
[Au] Autor:Rosenberg K
[Ti] Título:Opioid and Nonopioid Analgesics Provide Similar Relief From Acute Extremity Pain.
[So] Source:Am J Nurs;118(2):69-70, 2018 02.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes
Analgésicos Opioides
[Mh] Termos MeSH secundário: Dor Aguda
Analgésicos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Non-Narcotic); 0 (Analgesics, Opioid)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000530254.99076.b2


  3 / 1348 MEDLINE  
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[PMID]:29240318
[Au] Autor:Brinck E; Kontinen V
[Ti] Título:Ketamine in the treatment of acute pain.
[So] Source:Duodecim;133(9):863-8, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Ketamine is an old anesthetic agent that relieves pain by reducing central sensitization in the central nervous system. This is advantageous for patients suffering from severe pain prior to surgery or are using a strong opioid. The S enantiomer of ketamine used for anesthesia is more powerful than racemic ketamine. The ideal dose of ketamine for pain relief is not yet known, and its adverse effects on the central nervous system, including hallucinations, sedation, and diplopia have limited its use in pain management. The significance of these effects at low doses is probably less than expected, particularly if benzodiazepines or an alpha-2 agonist, such as dexmedetomidine, are administered in addition to ketamine.
[Mh] Termos MeSH primário: Dor Aguda/tratamento farmacológico
Anestésicos Dissociativos/uso terapêutico
Ketamina/uso terapêutico
Manejo da Dor
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  4 / 1348 MEDLINE  
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[PMID]:29189368
[Au] Autor:Monitto CL; Hsu A; Gao S; Vozzo PT; Park PS; Roter D; Yenokyan G; White ED; Kattail D; Edgeworth AE; Vasquenza KJ; Atwater SE; Shay JE; George JA; Vickers BA; Kost-Byerly S; Lee BH; Yaster M
[Ti] Título:Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge.
[So] Source:Anesth Analg;125(6):2113-2122, 2017 12.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy. METHODS: Using a scripted 10-minute interview, parents of 343 pediatric inpatients (98% postoperative) treated at a university children's hospital were questioned within 48 hours and 10 to 14 days after discharge to determine amount of opioid prescribed and consumed, duration of treatment, and disposition of unconsumed opioid. Multivariable linear regression was used to examine predictors of opioid prescribing, consumption, and doses remaining. RESULTS: Median number of opioid doses dispensed was 43 (interquartile range, 30-85 doses), and median duration of therapy was 4 days (interquartile range, 1-8 days). Children who underwent orthopedic or Nuss surgery consumed 25.42 (95% confidence interval, 19.16-31.68) more doses than those who underwent other types of surgery (P < .001), and number of doses consumed was positively associated with higher discharge pain scores (P = .032). Overall, 58% (95% confidence interval, 54%-63%) of doses dispensed were not consumed, and the strongest predictor of number of doses remaining was doses dispensed (P < .001). Nineteen percent of families were informed how to dispose of leftover opioid, but only 4% (8 of 211) did so. CONCLUSIONS: Pediatric providers frequently prescribed more opioid than needed to treat pain. This unconsumed opioid may contribute to the epidemic of nonmedical use of prescription opioids. Our findings underscore the need for further research to develop evidence-based opioid prescribing guidelines for physicians treating acute pain in children.
[Mh] Termos MeSH primário: Dor Aguda/tratamento farmacológico
Analgésicos Opioides/administração & dosagem
Prescrições de Medicamentos
Alta do Paciente/tendências
[Mh] Termos MeSH secundário: Dor Aguda/diagnóstico
Adolescente
Criança
Pré-Escolar
Prescrições de Medicamentos/normas
Feminino
Seres Humanos
Lactente
Masculino
Alta do Paciente/normas
Estudos Prospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002586


  5 / 1348 MEDLINE  
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[PMID]:29189367
[Au] Autor:Chai PR; Carreiro S; Innes BJ; Chapman B; Schreiber KL; Edwards RR; Carrico AW; Boyer EW
[Ti] Título:Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills.
[So] Source:Anesth Analg;125(6):2105-2112, 2017 12.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opioid analgesics are commonly prescribed on an as-needed (PRN) basis for acute painful conditions. Uncertainty of how patients actually take PRN opioids, coupled with a desire to completely cover pain, leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids. This opioid surplus becomes a source for diversion and nonmedical opioid use. Understanding patterns of actual opioid ingestion after acute painful conditions can help clinicians counsel patients on safe opioid use, and allow timely recognition and intervention when escalating opioid self-dosing occurs, to prevent tolerance and addiction. METHODS: We used a novel oxycodone digital pill system (ingestible biosensor within a standard gelatin capsule combined with 5-mg oxycodone) that when ingested, is activated by the chloride ion gradient in the stomach thereby emitting a radiofrequency signal captured by a wearable reader. The reader relays ingestion data to a cloud-based server that displays ingestion events to the study team. We deployed the oxycodone digital pill among opioid-naive individuals discharged from the emergency department with acute fracture pain. Participants were trained on digital pill operation and discharged with twenty-one 5-mg oxycodone digital pills. They were instructed to take digital pills PRN for pain on discharge. We conducted a brief interview 7 days after study enrollment, at which point participants returned the digital pill system. We identified oxycodone ingestion events in real time by data from the digital pill system and performed pill counts at the return visit to validate digital pill reporting of medication ingestion. RESULTS: In this study, 26 individuals were approached; 16 enrolled with 15 completing the study. Participants ingested a median of 6 (3-9.5) oxycodone digital pills over the course of 7 days, with 82% of the oxycodone dose ingested in the first 3 days. In individuals who required operative repair, 86% (N = 6) continued to ingest opioids at 1 week. There was substantial variability in ingestion patterns between individuals. CONCLUSIONS: The utilization patterns of individuals with acute fracture pain could be captured using a digital pill system and revealed a median opioid ingestion of 45-mg morphine equivalents for acute pain over 7 days. Seven participants ceased using opioids within 4 days after discharge from the emergency department, although operative repair was associated with longer use. This digital pill system was able to measure changes in and patterns of opioid self-dosing, which varied between patients.
[Mh] Termos MeSH primário: Dor Aguda/tratamento farmacológico
Analgésicos Opioides/administração & dosagem
Técnicas Biossensoriais/métodos
Fraturas Ósseas/tratamento farmacológico
Aplicações da Informática Médica
Adesão à Medicação
Oxicodona/administração & dosagem
[Mh] Termos MeSH secundário: Dor Aguda/diagnóstico
Dor Aguda/etiologia
Adulto
Idoso
Técnicas Biossensoriais/instrumentação
Cápsulas
Serviço Hospitalar de Emergência
Feminino
Fraturas Ósseas/complicações
Fraturas Ósseas/diagnóstico
Seres Humanos
Masculino
Meia-Idade
Projetos Piloto
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Capsules); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002574


  6 / 1348 MEDLINE  
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[PMID]:27772681
[Au] Autor:Cozzi G; Guastalla V; Barbi E
[Ad] Endereço:Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
[Ti] Título:Adolescent Athlete With Sudden Groin Pain.
[So] Source:Ann Emerg Med;68(5):639-648, 2016 Nov.
[Is] ISSN:1097-6760
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Dor Aguda/etiologia
Traumatismos em Atletas/diagnóstico por imagem
Fratura Avulsão/diagnóstico por imagem
Virilha/lesões
Ílio/lesões
[Mh] Termos MeSH secundário: Dor Aguda/diagnóstico por imagem
Adolescente
Traumatismos em Atletas/complicações
Traumatismos em Atletas/terapia
Fratura Avulsão/etiologia
Fratura Avulsão/terapia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  7 / 1348 MEDLINE  
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[PMID]:28466621
[Au] Autor:Jacob R; Shavit I
[Ad] Endereço:Department of Emergency Medicine, Ruth Children's Hospital, Rambam Healthcare Campus, Haifa, Israel.
[Ti] Título:Emergency Department Pain Management of Acute Abdominal Pain and Acute Appendicitis in Children.
[So] Source:Isr Med Assoc J;18(11):689-691, 2016 Nov.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Dor Abdominal/diagnóstico
Dor Aguda/diagnóstico
Apendicite/diagnóstico
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Dor Abdominal/terapia
Doença Aguda
Dor Aguda/etiologia
Dor Aguda/terapia
Criança
Serviço Hospitalar de Emergência
Seres Humanos
Medição da Dor/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


  8 / 1348 MEDLINE  
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[PMID]:27771314
[Au] Autor:Budiansky AS; Margarson MP; Eipe N
[Ad] Endereço:Univerity of Ottawa, Ottawa, ON, Canada.
[Ti] Título:Acute pain management in morbid obesity - an evidence based clinical update.
[So] Source:Surg Obes Relat Dis;13(3):523-532, 2017 Mar.
[Is] ISSN:1878-7533
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Increasing numbers of patients with morbid obesity are presenting for surgery and their acute pain management requires an evidence-based clinical update. The objective of this study was to complete a literature review for acute pain management in morbid obesity and provide an evidence-based clinical update with recommendations. Using standardized search terms, in March 2015, we completed a literature search to determine evidence for different acute pain pharmacological modalities in morbid obesity. For each modality the highest level of evidence was ascertained and recommendations for each pharmacological modality are presented. Though overall evidence is limited to few well conducted clinical trials, mostly related to weight loss surgery, multimodal analgesia with step-wise, severity-based, opioid-sparing approach appears to improve acute pain management in morbid obesity. The perioperative use of non-opioid adjuvants appears to offer further improvements in patient safety and outcomes. Further research into standardization of pain assessments and implementation of acute pain management protocols is required.
[Mh] Termos MeSH primário: Dor Aguda/prevenção & controle
Analgésicos/uso terapêutico
Cirurgia Bariátrica/efeitos adversos
Obesidade Mórbida/cirurgia
[Mh] Termos MeSH secundário: Analgesia/métodos
Quimioterapia Adjuvante
Terapia Combinada
Seres Humanos
Manejo da Dor/métodos
Dor Pós-Operatória/prevenção & controle
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  9 / 1348 MEDLINE  
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[PMID]:28906391
[Au] Autor:Liu B; Liu R; Wang L
[Ad] Endereço:aDepartment of Anesthesiology, Linyi People's Hospital bDepartment of Anesthesiology, Women and Children's Health Care Hospital of Linyi, Shandong, China.
[Ti] Título:A meta-analysis of the preoperative use of gabapentinoids for the treatment of acute postoperative pain following spinal surgery.
[So] Source:Medicine (Baltimore);96(37):e8031, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gabapentinoid drugs, which include gabapentin and pregabalin, play an established role in the management of neuropathic pain. However, whether preoperative administration of gabapentinoids has a beneficial role in controlling acute pain after spinal surgery is unknown. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy and safety of the preoperative use of gabapentinoids (gabapentin and pregabalin) for the treatment of acute postoperative pain following spinal surgery. METHODS: In March 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Library, and Google databases. RCTs comparing gabapentinoids (gabapentin and pregabalin) with placebo in patients undergoing spine surgery were retrieved. The primary endpoint was the visual analogue scale (VAS) score with rest or mobilization at 6, 12, 24, and 48 hours and cumulative morphine consumption at 24 and 48 hours. The secondary outcomes were complications of nausea, vomiting, sedation, dizziness, headache, urine retention, pruritus, and visual disturbances. After tests for publication bias and heterogeneity among studies were performed, data were aggregated for random-effects models when necessary. RESULTS: Sixteen clinical studies (gabapentin group n = 8 and pregabalin group n = 8) were ultimately included in the meta-analysis. Gabapentinoids were associated with reduced pain scores at 6, 12, 24, and 48 hours. Similarly, gabapentinoids were associated with a reduction in cumulative morphine consumption at 24 and 48 hours. Furthermore, gabapentinoids can significantly reduce the occurrence of nausea, vomiting, and pruritus. There were no significant differences in the occurrence of sedation, dizziness, headache, visual disturbances, somnolence, or urine retention. CONCLUSIONS: Preoperative use of gabapentinoids was able to reduce postoperative pain, total morphine consumption, and morphine-related complications following spine surgery. Further studies should determine the optimal dose and whether pregabalin is superior to gabapentin in controlling acute pain after spine surgery.
[Mh] Termos MeSH primário: Dor Aguda/tratamento farmacológico
Aminas/uso terapêutico
Analgésicos/uso terapêutico
Ácidos Cicloexanocarboxílicos/uso terapêutico
Dor Pós-Operatória/tratamento farmacológico
Pregabalina/uso terapêutico
Coluna Vertebral/cirurgia
Ácido gama-Aminobutírico/uso terapêutico
[Mh] Termos MeSH secundário: Dor Aguda/etiologia
Aminas/efeitos adversos
Analgésicos/efeitos adversos
Ácidos Cicloexanocarboxílicos/efeitos adversos
Seres Humanos
Pregabalina/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Ácido gama-Aminobutírico/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Amines); 0 (Analgesics); 0 (Cyclohexanecarboxylic Acids); 55JG375S6M (Pregabalin); 56-12-2 (gamma-Aminobutyric Acid); 6CW7F3G59X (gabapentin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008031


  10 / 1348 MEDLINE  
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[PMID]:28904722
[Au] Autor:Guennoun A; Krimou Y; Mamouni N; Errarhay S; Bouchikhi C; Banani A
[Ad] Endereço:Departement de Gynécologie ObstétriqueI, Hôpital Univiersitaire Hassan II, Fez, Maroc.
[Ti] Título:[Normal adnexal torsion and pregnancy: about a case].
[Ti] Título:Torsion d'annexe saine et grossesse: à propos d'un cas..
[So] Source:Pan Afr Med J;27:197, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Normal adnexal torsion is rare during pregnancy. We here report the case of a 22-year old patient presenting with acute lateropelvic pain associated with a 2-month history amenorrhea. Exploratory laparotomy showed severe ischemia due to torsion in a normal ovary. The patient underwent adnexal detorsion without ovarian pexy. The postoperative course was uneventful. Ultrasound examination after 3 weeks showed normal pregnancy. Ovarian torsion is an emergency that should not be ignored in pregnant women with acute pelvic pain. Conservative treatment is the gold standard and proper management is necessary to avoid possible maternal and fetal complications.
[Mh] Termos MeSH primário: Doenças Ovarianas/diagnóstico
Dor Pélvica/etiologia
Complicações na Gravidez/diagnóstico
Anormalidade Torcional/diagnóstico
[Mh] Termos MeSH secundário: Dor Aguda/etiologia
Doenças dos Anexos/diagnóstico
Doenças dos Anexos/cirurgia
Feminino
Seres Humanos
Isquemia/etiologia
Laparotomia/métodos
Doenças Ovarianas/cirurgia
Gravidez
Complicações na Gravidez/cirurgia
Anormalidade Torcional/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.197.12250



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