Minimal Use of Opioids for Pain Relief in an Internal Medicine Department

Southern Medical Journal
Zvi ShimoniPaul Froom

Abstract

The objective of the study was to determine if pain control was adequate despite our policy of limited opioid use. In this observational cohort study, we reviewed 300 consecutive patient charts from an internal medicine department. We extracted demographic data, as well as the patients' primary diagnosis, pain on admission, daily pain evaluations (numerical rating score [NRS]), and treatment. Significant pain was defined as a score of ≥3 on the NRS. We determined the incidence of pain and pain control and reviewed the charts of those with an NRS ≥3 for ≥3 days to determine the need for opioid therapy. Of 1692 total hospitalization days in the 300 consecutive patients with a median age of 80 years (1st-3rd quartiles, 65-87 years) there were 204 days with complaints of pain (12.1%) and 149 days (8.8%) with reports of pain of ≥3 on the NRS. Overall, 28.3% (85 of 300) of the patients had significant pain during their hospitalization. Most of the pain, however, (80.0%, 68 of 85) was short-term (1-2 days) whether or not the patient received pain medication. Pain relief treatment in the hospital included opioids in 17 (5.7%, 95% confidence interval [CI] 3.5-8.9) and dipyrone in 36 (12%, 95% CI 8.8-16) of the 300 patients. Pain control...Continue Reading

References

Apr 10, 1999·Journal of Advanced Nursing·M de RondB van Campen
Nov 19, 2003·The Journal of Pain : Official Journal of the American Pain Society·Mark P JensenAndrew M Brugger
Feb 23, 2005·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Ruth StalnikowiczMayer Brezis
Jan 18, 2006·European Journal of Pain : EJP·A VallanoUNKNOWN Catalan Research Group for Studying Pain in Hospital
Sep 15, 2006·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A A MartoniS Giaquinta
May 20, 2008·British Journal of Anaesthesia·H BreivikA Stubhaug
Nov 13, 2008·Pain Practice : the Official Journal of World Institute of Pain·Bill McCarberg, Steven Stanos
Aug 21, 2010·American Journal of Public Health·Cynthia I CampbellMichael Von Korff
Dec 7, 2013·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Hilary J MosherMark W Vander Weg
Nov 11, 2015·Journal of General Internal Medicine·Susan L CalcaterraIngrid A Binswanger
Dec 14, 2016·The New England Journal of Medicine·Vivek H Murthy

❮ Previous
Next ❯

Citations

Jan 16, 2020·Proceedings of the National Academy of Sciences of the United States of America·Justine S HastingsSarah E Inman

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.