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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
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Opioid Receptors: Overview01:22

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Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
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Reducing Opioid Use in Orthopaedic Surgery.

Horneff John G, Abboud Joseph Albert, Antonia F Chen

    Instructional Course Lectures
    |January 2, 2025
    PubMed
    Summary

    Orthopaedic surgeons can combat the opioid crisis by implementing multimodal pain management strategies. These approaches reduce opioid prescriptions and minimize risks associated with opioid use.

    Area of Science:

    • Orthopaedic Surgery
    • Pain Management
    • Public Health

    Background:

    • The United States has faced a significant opioid crisis since the mid-1990s.
    • Opioid misuse presents a major challenge for healthcare providers, particularly in orthopaedic surgery.

    Purpose of the Study:

    • To outline preoperative, intraoperative, and postoperative strategies for orthopaedic surgeons to reduce opioid consumption.
    • To highlight methods for mitigating the risks associated with opioid use in surgical patients.

    Main Methods:

    • Utilizing preoperative screening tools to identify patients at risk for prolonged opioid use.
    • Implementing patient education initiatives on postoperative pain management.
    • Employing local and regional anesthesia during surgery.

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  • Exploring alternative postoperative pain therapies like acetaminophen, NSAIDs, and cryotherapy.
  • Practicing prudent opioid prescribing habits and managing refills.

    • Main Results:

    • Preoperative screening aids in tailored patient interventions.
    • Patient education effectively decreases postoperative opioid consumption.
    • Regional anesthesia minimizes postoperative pain and opioid needs.
    • Alternative therapies provide viable non-opioid pain management options.
    • Judicious prescribing reduces excess opioid supply and diversion.

    Conclusions:

    • Orthopaedic surgeons should adopt a multimodal pain management approach.
    • Integrating various strategies can optimize patient outcomes and reduce opioid-related risks.
    • Decreasing opioid prescriptions is crucial for addressing the ongoing opioid crisis.