Examination Of Surgical Abdominal Cancer Surgery Essay

Narcotic analgesics, especially morphine are underused for pain control with in the medical field. This underuse is because medical professionals, including doctors, fear patient addiction, side effects and possible lose of their licenses. These fears deny adequate healing and a better quality of life to those who would benefit from a more effective use of these drugs, as done in hospice care.

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

Methadone is one of the most common medications used to treat opioid addiction. It decreases the symptoms of opioid withdrawal and inhibits the euphoric effects caused by abusing heroin and prescription opioids such as oxycodone. When used as prescribed and under the supervision of a trained physician, methadone is an effective complement to treatment. SAMHSA also recommends patients remain on methadone treatment for at least 12 months. Many people require multiple years of treatment. When discontinuing methadone treatment, patients should slowly taper off of it under doctor supervision. Buprenorphine decreases the potential for opioid abuse, reduces withdrawal symptoms and cravings and decreases the risks of overdose. Because buprenorphine

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

Naloxone is added to buprenorphine for the treatment of opiate dependence and to prevent intravenous diversion [11]. However, the efficacy of buprenorphine is not affected by the combination because the half-life for buprenorphine is

Pharmacy has been consulted regarding: How do the outcomes compare between buprenorphine-containing treatment options and methadone in opioid-dependent patients in terms of efficacy?

With the increase of medical availability of buprenorphine there have been concerns about the abuse potential. There have been international cases of misuse and abuse-related morbidity and mortality. In Finland, intravenous abuse of these drugs has been

Next, there is an extensive history of opioid use for pain management, and other symptom management as well. Morphine can be traced back to Civil War veterans trying to manage pain and, consequently, being addicted. “‘Drugs were already on the scene and being consumed at alarming rates long before the start of the war,’ said Mark A Quinoes, a scholar who studied drug abuse during the Civil War.” It was not until 1898 that heroin was on the market for commercial sale, considered a “wonder drug,” it began to spread in use along with users that found out injecting it would increase its effects. There was little known about these new opioids, they were even used as cough suppressants. Heroin worked for what is was being used as, a pain suppressant, and there were few other options. In 1914 the Harrison Narcotics Tax Act imposed a tax on importing and selling opium or coca leaves. In 1924 doctors were avoiding using opioids after being aware of their addictive nature which lead heroin becoming illegal. Without this opioid, doctors had to get creative when treating World War II soldiers, this sparked research into nerve blockers. These nerve blockers managed pain without the use of surgery. This was, unfortunately, not the end of the opioid. While these results were shocking the pharmaceutical industry still faces much leniency from the federal

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

Opioids are effective for the treatment of acute pain, such as pain following surgery. They have also been found to be important in palliative care (hospice) to help with the severe, chronic, disabling pain that may occur in some terminal conditions such as cancer. In many cases opioids are successful long-term care strategies for those with chronic cancer pain (CCP). There are not many alternatives for those with CCP like there are for those suffering acute or chronic non cancer pain (CNCP). In one study, conducted by Furlan et al. (2006), opioids were effective in the treatment of CNCP overall; they reduced pain and improved functional outcomes better than placebo. Strong opioids (oxycodone and morphine) were significantly superior, to naproxen and nortriptyline (respectively) for pain relief but not for functional outcomes. Unfortunately, Weak opioids (propoxyphene, tramadol and codeine) did not significantly outperform NSAIDs or TCAs for either pain relief or functional outcomes. Overall, if opioids are

For patients that have previously misused medication or are predisposed to addiction, opioids are not always an option for pain management. In this case, doctors use MATs, Medication Assisted Treatment, which offers a plan in order to treat addiction and offer pain relief at the same time. By offering sufficient amounts of dosage for an acceptable duration, MATs increase the length of abstinence in these patients. It has also been proven that, “MAT interventions also suppress withdrawal symptoms, extinguishing cravings, and block the reinforcing effects of the abused opioid agents” (Leahy). Buprenorphine is prescribed to women that are pregnant and is often the most popular of MATs, for it does not react with other drugs, allowing doctors

Opioid-induced adverse effects are a very interesting topic and does play a big part in patient safety. It’s estimated that more than half of older adults who reside in a healcre related community have a chronic pain disorder, with the long-term care setting rate of prevalence substantially increased (up to almost 90%). Physicians across all care settings are tasked with the daunting challenge of providing pain relief while, at the same time, minimizing opioid-induced side effects. Some of the common opioid-induced side effects are Constipation, Nausea, Vomiting, Pruritus, Sweating, Sedation, Fatigue, Headache, Delirium, Confusion, Clouded vision, Dizziness, Xerostomia, Postural Hypotension, Bladder Dysfunction such as Urinary Retention,

however, these effects are weaker than those of full drugs such as heroin and methadone”

Opioids are commonly used in the intensive care unit (ICU) to control painful conditions and overall to alleviate the intensity of pain. Clinical uses of opioids has been occurring for thousands of years and includes pain relief of acute pain post surgery, injury or trauma, cancer pain and pain from chronic and disabling diseases. Two conventional opioids used in the ICU are morphine and fentanyl. Although both are used, one appears to have greater benefits through patient outcomes and lower costs with that being fentanyl as the preferred opioid in the ICU in both adults and children. Yet, morphine and fentanyl are still being used interchangeably in the ICU. It is uncertain whether physicians know that costs are decreased and adverse reactions

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).