Review
Anesthesiology
Celeste A. Mallama, Christina Greene, Apostolos A. Alexandridis, Jana K. McAninch, Gerald Dal Pan, Tamra Meyer
Summary: The use of outpatient opioid analgesics reported by patients after surgery varies widely across different types of procedures, with knee and hip arthroplasty showing the highest usage. Many procedures resulted in reported usage of less than 5 tablets.
Article
Oncology
Nicholas W. Eyrich, Kenneth R. Sloss, Ryan A. Howard, Michael P. Klueh, Michael J. Englesbe, Jennifer F. Waljee, Chad M. Brummett, Michael S. Sabel, Lesly A. Dossett, Jay S. Lee
Summary: The study found that opioid prescribing exceeds consumption following common surgical oncology procedures. While most patients received education on taking opioids, few received instructions on proper disposal, leading to a high percentage of unused opioids.
JOURNAL OF SURGICAL ONCOLOGY
(2021)
Article
Anesthesiology
Gina Votta-Velis, Martha L. Daviglus, Alain Borgeat, Katharina Beckmann, Andrew Q. Ta, John L. Parker, Sasha Kravets, Olga L. Garcia, Amber Pirzada, Nicole Gastala, Valentina Valle, Jamie J. Benken, Maya Campara, Gabriela Aguiluz, Stavros G. Memtsoudis, Pier C. Giulianotti, Enrico Benedetti
Summary: This study evaluated the effectiveness of a surgical opioid-avoidance protocol (SOAP) on postoperative pain scores in a diverse patient population. The SOAP group, which followed a strict opioid-avoidance order set and received patient and staff education, showed non-inferior postoperative pain scores compared to the non-SOAP group. Additionally, the SOAP group had lower opioid consumption and fewer prescription opioids upon discharge.
REGIONAL ANESTHESIA AND PAIN MEDICINE
(2023)
Article
Anesthesiology
Josh Bleicher, Benjamin Sands Brooke, Kimberlee Bayless, Zachary Anderson, Julie Beckstrom, Chong Zhang, Angela P. Presson, Lyen C. Huang, Michael Jacob Buys
Summary: Understanding the patterns of postoperative opioid use among different populations is important for developing opioid stewardship programs. This retrospective study investigated opioid prescribing, use, and pain after general surgery procedures for patients at a veterans administration hospital. The results showed that both non-opioid users and chronic opioid users required very few opioids after surgery, and chronic opioid users quickly returned to their baseline opioid use. There was no difference in pain recovery between the two groups. The study suggests that opioid prescribing guidelines should consider including chronic opioid therapy patients and recommend a more conservative approach.
REGIONAL ANESTHESIA AND PAIN MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Timothy M. Markman, Chase R. Brown, Lin Yang, Gustavo S. Guandalini, Matthew C. Hyman, Jeffrey S. Arkles, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, Rajat Deo, Saman Nazarian, Sanjay Dixit, David J. Callans, Andrew E. Epstein, Francis E. Marchlinski, Peter W. Groeneveld, David S. Frankel
Summary: This study investigated the incidence of persistent opioid use in patients who were opioid-naive after cardiac implantable electronic device (CIED) procedures. The results showed that 12% of patients continued to use opioids >30 days after surgery, and higher initially prescribed oral morphine equivalent doses were associated with developing persistent opioid use.
Article
Surgery
Brian D. Lo, George Q. Zhang, Joseph K. Canner, Miloslawa Stem, James P. Taylor, Chady Atallah, Jonathan E. Efron, Bashar Safar
Summary: This study found an association between preoperative opioid dose and surgical outcomes among adult colectomy patients, showing a dose-response relationship of increasing opioid dose with higher risk of postoperative complications.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2022)
Article
Health Care Sciences & Services
Sarah Kosakowski, Allyn Benintendi, Pooja Lagisetty, Marc R. Larochelle, Amy S. B. Bohnert, Angela R. Bazzi
Summary: Patients on long-term opioid therapy for chronic pain described generally adverse experiences with opioid tapers. These tapers can lead to significant physical, emotional, and social consequences, often reducing trust and engagement in healthcare. Patient-provider relationships and communication play a crucial role in patients' perceptions of the quality and outcomes of opioid tapers.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Medicine, General & Internal
Natasa Gisev, Luke Buizen, Ria E. Hopkins, Andrea L. Schaffer, Benjamin Daniels, Chrianna Bharat, Timothy Dobbins, Sarah Larney, Fiona Blyth, David C. Currow, Andrew Wilson, Sallie-Anne Pearson, Louisa Degenhardt
Summary: The objective of this population-based cohort study was to identify 5-year trajectories of prescription opioid use and examine the characteristics of each trajectory group. The results suggest that most individuals initiating treatment with prescription opioids had relatively low and time-limited exposure over a 5-year period. A small proportion of individuals had sustained or increasing use, and they were typically older with more comorbidities and higher use of psychotropic and other analgesic drugs.
Article
Anesthesiology
Anne C. Fernandez, Lewei A. Lin, Angela R. Bazzi, Jeff Boissoneault, Brian Borsari, Frederic Blow
Summary: This study conducted interviews with elective surgical patients with unhealthy alcohol use to better understand their beliefs and behaviors related to opioid use, alcohol use, and pain management in the perioperative context. Three key themes were identified regarding alcohol use, opioid use, and their co-use before and after surgery, showing variations in desires and intentions for opioid use, preferences for alcohol as a pain management strategy, and a range of beliefs about the risks and benefits of alcohol and opioid co-use among the participants.
Article
Surgery
Rathnayaka M. K. D. Gunasingha, Injamamul L. Niloy, Berish B. Wetstein, Peter A. Learn, Lauren C. Turza
Summary: This study investigated postoperative opioid usage among patients undergoing breast surgeries and recommended a set number of opioid pills for discharge. The results indicate that most breast surgery patients can be discharged with fewer than 10 opioid pills, except under special circumstances. Utilization of a standardized discharge opioids protocol can effectively reduce the number of opioids prescribed to patients.
Article
Anesthesiology
Jiyeon Song, Yi Li, Jennifer F. Waljee, Vidhya Gunaseelan, Chad M. Brummett, Michael J. Englesbe, Mark C. Bicket
Summary: To develop precise opioid prescribing guidelines after surgery, it is important to understand patterns of patient-reported opioid consumption. This study analyzed data from over 10,000 surgical patients and found that many did not use any opioids after surgery. The study highlights the need for further investigation to ensure tailored recommendations for postoperative pain management.
REGIONAL ANESTHESIA AND PAIN MEDICINE
(2023)
Article
Medicine, General & Internal
Anish K. Agarwal, Daniel Lee, Zarina Ali, Brian Sennett, Ruiying Xiong, Jessica Hemmons, Evan Spencer, Dina Abdel-Rahman, Rachel Kleinman, Hannah Lacko, Annamarie Horan, Mary Dooley, Eric Hume, Samir Mehta, M. Kit Delgado
Summary: This study evaluated the difference between opioid tablets prescribed and self-reported usage, pain intensity, and pain management ability after orthopedic and urologic procedures using an automated text messaging system. The findings revealed discrepancies between prescribed and consumed quantities, with a significant proportion of patients not using any opioids.
Article
Anesthesiology
Basavana Goudra, Arjun Guthal, Preet Mohinder Singh
Summary: The study examined postoperative opioid consumption in orthopedic surgical patients, finding that some patients experienced euphoria, some switched to marijuana, some opted not to use opioids at all post-surgery, and even shared their prescriptions with family or friends.
Article
Oncology
Soraira Pacheco, Linh M. T. Nguyen, John M. Halphen, Nikitha N. Samy, Nathaniel R. Wilson, Gregory Sattler, Shane E. Wing, Christine Feng, Rex A. D. Paulino, Pulin Shah, Supriyanka Addimulam, Riddhi Patel, Curtis J. Wray, Joseph A. Arthur, David Hui
Summary: Patient prescriber agreements (PPAs) are recommended as a strategy for mitigating non-medical opioid use (NMOU) in cancer patients. Our study found that 54% of patients had a PPA, and 10% were not adherent. PPAs were associated with younger age and alcohol use, while non-adherence was associated with males, being single, tobacco and alcohol use, contact with persons involved in criminal activity, opioid use for non-cancer pain, and higher pain score.
Article
Multidisciplinary Sciences
Cassandra Iroz, Willemijn Schaefer, Julie Johnson, Meagan Ager, Reiping Huang, Salva Balbale, Jonah Stulberg, Opioid Agreement Delphi Group
Summary: This study aimed to generate consensus on the content of a safe opioid use agreement for the perioperative settings to improve patients' safe use, storage, and disposal of opioids.
Editorial Material
Anesthesiology
Karsten Bartels, Joseph P. Schacht
ANESTHESIA AND ANALGESIA
(2021)
Review
Anesthesiology
Kevin K. Kim, Martin Krause, Ivo F. Brandes, Ashish K. Khanna, Karsten Bartels
Summary: This review highlights the recent findings on the utilization of TEE during thoracic surgical procedures, emphasizing its common use in high-risk surgeries like lung transplantation and pulmonary thromboendarterectomy. While TEE is not usually required for common thoracic surgeries, it may be used to elucidate reasons for acute hemodynamic instability without apparent cause. Most recommendations in this field are expert opinion-based, and routine use of TEE in thoracic surgery is often limited to specific high-risk patients and procedures.
CURRENT OPINION IN ANESTHESIOLOGY
(2021)
Article
Anesthesiology
David J. Douin, Martin Krause, Cynthia Williams, Kenji Tanabe, Ana Fernandez-Bustamante, Aurora N. Quaye, Adit A. Ginde, Karsten Bartels
Summary: The study found an association between corticosteroid administration and higher incidence of both hyperglycemia and hypoglycemia in COVID-19 patients requiring mechanical ventilation.
SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2022)
Editorial Material
Anesthesiology
Karsten Bartels, Daniel Sessler
Summary: Meta-analyses are important for guiding clinical trials and care, but they can be affected by methodologic problems and biases in the underlying trials. Publication bias often leads to overestimation of benefits in small trials, but this can be corrected by subsequent large trials. It is essential to conduct large, robust trials as they are irreplaceable by meta-analyses.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Article
Anesthesiology
Megan L. Rolfzen, Susan K. Mikulich-Gilbertson, Crystal Natvig, Jacqueline A. Carrico, Robert L. Lobato, Martin Krause, Karsten Bartels
Summary: The study found a significant association between alcohol use disorder and increased in-hospital mortality, length of stay, and hospitalization costs in patients undergoing colectomy. This highlights the importance of identifying patients with alcohol use disorder prior to surgery to provide more effective perioperative interventions.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Anesthesiology
Karsten Bartels, Gyorgy Frendl, Juraj Sprung, Toby N. Weingarten, Balachundhar Subramaniam, Ricardo Martinez Ruiz, Jae-Woo Lee, William G. Henderson, Angela Moss, Alissa Sodickson, Jadelis Giquel, Marcos Francisco Vidal Melo, Ana Fernandez-Bustamante
Summary: For non-cardiothoracic surgery patients, adjuvant regional anesthesia is not associated with a higher incidence of postoperative pulmonary complications compared to general anesthesia alone.
BMC ANESTHESIOLOGY
(2022)
Editorial Material
Anesthesiology
Martin Krause, Karsten Bartels
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2022)
Correction
Anesthesiology
Megan L. Rolfzen, Susan K. Mikulich-Gilbertson, Crystal Natvig, Jacqueline A. Carrico, Robert L. Lobato, Martin Krause, Karsten Bartels
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Anesthesiology
Joseph E. Morabito, Colby G. Simmons, Giorgio Zanotti, John D. Mitchell, Karsten Bartels, Barbara J. Wilkey
Summary: The translation provides an in-depth understanding of a case report on a 44-year-old male with tracheal tumors who underwent surgery. The case was complicated by bleeding and hemodynamic instability during the operation, leading to the abortion of surgical resection. Pathologic examination revealed a rare type of tracheal tumor called primary tracheal plasmacytoma. The article discusses the anesthetic and hemodynamic considerations for this condition, as well as the unpredictability of tracheal tumors.
SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2023)
Article
Anesthesiology
Megan L. Rolfzen, Abraham Wick, Edward J. Mascha, Karan Shah, Martin Krause, Ana Fernandez-Bustamante, Jean S. Kutner, P. Michael Ho, Daniel I. Sessler, Karsten Bartels
Summary: This study examined the impact of a decision-support tool embedded in electronic health records on the quantity of opioids prescribed at discharge after inpatient surgery. The results showed that the tool did not reduce opioid prescribing during the postoperative period, despite the presence of a robust opioid education and awareness campaign.
Editorial Material
Anesthesiology
Karsten Bartels, Amanda A. Fox
Editorial Material
Anesthesiology
Megan L. Rolfzen, Karsten Bartels
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Correction
Anesthesiology
Megan L. Rolfzen, Karsten Bartels
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Article
Pharmacology & Pharmacy
Jesse D. Hinckley, Laura Saba, Kristen Raymond, Karsten Bartels, Jost Klawitter, Uwe Christians, Christian Hopfer
Summary: This study used a multi-omics approach to examine the molecular pathways influenced by cannabis use in humans. The results showed that protein, metabolomic, and lipid markers in plasma were associated with THC-COOH levels, and these markers were linked with immune system-related pathways.
CANNABIS AND CANNABINOID RESEARCH
(2022)
Review
Critical Care Medicine
Dustin C. Krutsinger, Kuldeep N. Yadav, Michael O. Harhay, Karsten Bartels, Katherine R. Courtright
Summary: In this systematic review and meta-analysis of recent ARDS/ALI and sepsis clinical trials, the overall enrollment rate was less than one participant per site per month, highlighting the need for novel approaches to improve critical care trial enrollment efficiency to translate best evidence into practice.