Opioids for chronic non-cancer pain

Freynhagen, Rainer; Geißlinger, Gerd; Schug, Stephan A.

doi:10.1136/bmj.f2937

Cited by 38 publications

(33 citation statements)

References 35 publications

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“…Opioids: Opioids bind to opioid receptors (μ, κ, δ), which are common in the brain, spinal cord and peripheral tissues. In meta-analyses they have been shown to be the most potent pain relievers in neuropathic pain [45]. Opioids have adverse effects on postoperative recovery due to side effects such as sedation, nausea, and constipation.…”

Section: A Medical Treatmentsmentioning

confidence: 99%

Current treatment options for post-thoracotomy pain syndrome: a review

Yakşi¹,

Yakşi²

2017

Curr Thorac Surg

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Thoracotomy is one of the most painful surgical procedures known. Chronic pain in the postoperative period after thoracotomy is a common complication. Post-thoracotomy pain syndrome (PTPS) is a chronic pain with neuropathic and non-neuropathic components, continuing after 2 months of thoracotomy, causing disability by affecting the daily activities and functions of patients. Patients generally describe neuropathic symptoms such as hyperalgesia, allodynia, hypoesthesia at the site of the incision or related dermatomes. Etiology includes preoperative, intraoperative and postoperative factors. Although the mechanism of PTPS formation is not clear yet, the most common cause is the intercostal nerve injury. PTPS treatment is complex because of the neuropathic component of the pain.The risk of PTPS formation can be reduced by controlling early pain before the onset of the disease.When pain occurs, medical treatments are implemented and also minimally invasive interventional procedures could be performed if necessary.

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Section: A Medical Treatmentsmentioning

confidence: 99%

Current treatment options for post-thoracotomy pain syndrome: a review

Yakşi¹,

Yakşi²

2017

Curr Thorac Surg

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“…[45,46] However, prolonged opioid use should be discouraged because it may increase the risk of an opioid use disorder or drug poisoning death. [47][48][49] Figure 3. Wong-Baker FACES R pain rating scale [44] Following hospital discharge, nurses continue to play an important role in patient recovery.…”

Section: Pseudarthrosismentioning

confidence: 99%

Nursing care of the patient undergoing lumbar spinal fusion

Lall

2017

JNEP

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Lumbar spinal fusion is a surgical procedure performed to join-or fuse-2 or more vertebrae in the low back. The procedure is done to stabilize the spine and prevent damage to the cauda equina and emanating nerve roots. Lumbar fusion is commonly indicated for patients with vertebral fractures, infection, or spinal tumors, and it may be appropriate for select patients with degenerative disorders and spinal stenosis. Nurses who care for patients undergoing lumbar fusion require an understanding of lumbar spinal anatomy, spinal pathology, surgical indications, and diagnostic modalities. Knowledge of the distinct surgical approaches and their respective advantages and disadvantages allows nurses to individualize patient care and be alert to postoperative complications. This article reviews clinical and research literature regarding lumbar fusion, with an emphasis on the role of the nurse in promoting a safe perioperative course.

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“…Indeed, the prevailing view was that 'strong' opioids such as morphine should be used more liberally, especially in acute settings. In practice, these agents were used primarily for severe acute pain in hospitals or for cancer pain in the community (Freynhagen 2013). There has been a significant increase in prescribing of high-potency opioids for non-cancer pain in recent decades, driven partly by aggressive marketing of these products (Freynhagen 2013).…”

Section: Misuse Of Prescribed Opioidsmentioning

confidence: 99%

“…In practice, these agents were used primarily for severe acute pain in hospitals or for cancer pain in the community (Freynhagen 2013). There has been a significant increase in prescribing of high-potency opioids for non-cancer pain in recent decades, driven partly by aggressive marketing of these products (Freynhagen 2013). Illicit prescription opioids have become the second most common illicit substance of misuse after cannabis (Weiss 2011).…”

Section: Misuse Of Prescribed Opioidsmentioning

confidence: 99%

Drug and alcohol addiction: new challenges

Luty

2014

Adv. psychiatr. treat

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SummaryThere have been many developments in addiction psychiatry over the past decade. Some of these are political, such as preference for recovery-/ abstinence-based programmes. Prohibition is becoming increasingly unrealistic, especially considering the effective legalisation of recreational cannabis in Uruguay and two US states. Legal highs and diversion of prescribed drugs (such as methadone, gabapentinoids, methylphenidate and benzodiazepines) are now a major problem. Furthermore, diversion of opioid drugs that are prescribed for pain is reaching epidemic proportions, causing a significant change in the nature of patients being referred to addiction services.Learning Objectives•Be aware of political issues regarding abstinence-based treatment and prohibition.•Be aware of risks and increased prevalence of diversion of drugs of misuse, especially opioid pain killers, gabapentinoids and benzodiazepines.•Update knowledge of problems with methadone such as cardiac arrhythmias and diversion.

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Opioids for chronic non-cancer pain

Cited by 38 publications

References 35 publications

Current treatment options for post-thoracotomy pain syndrome: a review

Current treatment options for post-thoracotomy pain syndrome: a review

Nursing care of the patient undergoing lumbar spinal fusion

Drug and alcohol addiction: new challenges

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