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Effectiveness and Safety of High-Dose Opioid Therapy

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 July 2019) | Viewed by 5907

Special Issue Editors


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Guest Editor
Department of Medicine, University of Alberta,Edmonton, Alberta T6G 1C9, Canada
Interests: pain medicine, occupational medicine, public health, systematic reviews

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Guest Editor
Department of Psychiatry, University of Alberta,Edmonton, Alberta T6G 2R7, Canada
Interests: occupational psychiatry, systematic reviews

Special Issue Information

Dear Colleagues,

Chronic non-cancer pain is very common in adults, occurring in approximately 20% of the population. The therapeutic use of opioids, especially for pain that is not due to cancer, and the use at high opioid doses, has been the subject of a growing and intense debate. Still, persons in the US and Canada are the highest per capita consumers of opioids globally, and a range of adverse effects and harms have been associated with opioid use, including addiction, overdose, and death.

This Special Issue is open to scientific studies that contribute further to this debate by addressing the efficacy and safety of high-dose opioids. This Special Issue will consider the following types of studies: clinical trials, cohort studies, case-control studies, case series, case reports, experimental studies, simulation studies, policy studies, opinion papers, narrative reviews, systematic reviews, and meta-analyses.

We look forward to receiving your submissions.

Dr. Sebastian Straube
Dr. Charl Els
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (1 paper)

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Review

12 pages, 303 KiB  
Review
Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review
by Olufunke Dada, Alicia Gonzalez Zacarias, Corinna Ongaigui, Marco Echeverria-Villalobos, Michael Kushelev, Sergio D. Bergese and Kenneth Moran
Int. J. Environ. Res. Public Health 2019, 16(18), 3257; https://doi.org/10.3390/ijerph16183257 - 5 Sep 2019
Cited by 61 | Viewed by 5685
Abstract
Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive [...] Read more.
Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. A search of relevant keywords was performed using PubMed, EMBASE, and Web of Science. Twenty-eight articles (n = 28) were included in our review. Perioperative considerations for peripheral nerve blocks and other alternatives used for postoperative pain management in patients undergoing orthopedic surgeries were discussed. Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption. Full article
(This article belongs to the Special Issue Effectiveness and Safety of High-Dose Opioid Therapy)
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