scholarly journals Opioid Rotation

2020 ◽  
Author(s):  
Keyword(s):  
2020 ◽  
Vol 10 (2) ◽  
pp. 27
Author(s):  
Grisell Vargas-Schaffer ◽  
Suzie Paquet ◽  
Andrée Neron ◽  
Jennifer Cogan

Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.


2009 ◽  
Vol 37 (6) ◽  
pp. 1061-1068 ◽  
Author(s):  
Miguel Angel Benítez-Rosario ◽  
Antonio Salinas-Martín ◽  
Armando Aguirre-Jaime ◽  
Lina Pérez-Méndez ◽  
Manuel Feria

Author(s):  
Raymond S. Sinatra
Keyword(s):  

2021 ◽  
Vol 10 (13) ◽  
pp. 0-0
Author(s):  
Luke P. Legakis ◽  
Wendy Woo ◽  
J. Brian Cassel ◽  
Egidio Del Fabbro

2021 ◽  
Author(s):  
John Cardenas ◽  
Juan Felipe Vargas-Silva ◽  
Alejandro Ramirez

Abstract Chronic pain of oncological origin is one of the most frequent complications and is difficult to control, that results in a decrease in the quality of life and disability among patients suffering from this pathology. Primary or metastatic tumors originating from lung, colonic, or breast neoplasms can invade the chest wall, causing progressive respiratory pain and symptoms that require multiple interventions to achieve adequate control. Many of these cases presenting with advanced-stage cancer are often incurable; thus, pain management and palliative care are primary objectives. Multimodal management is the strategy of choice in these cases through the participation of a multidisciplinary team. Analgesic therapy covers the use of potent opioids, opioid rotation, adjuvant analgesics, and interventional pain management strategies. We report two cases of chronic oncological pain of the chest wall refractory to pharmacological analgesic management. The optimization of multimodal management and the performance of neurolysis by phenolization of the erector spinae plane achieved an adequate response.


2013 ◽  
pp. 2463-2466
Author(s):  
Russell K. Portenoy ◽  
Ebtesam Ahmed

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