Influence Of Iv Acetaminophen On Opioid Use For Postoperative Pain

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

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 issue of pain management has been an ongoing crisis for ages. The need for solutions and methods of avoiding pain is natural, however, as time has passed, misuse of these solutions has gotten out of hand. The abuse of prescription opioids, in particular, must be acknowledged. By prescribing opioids to patients, doctors are inadvertently creating drug addicts and fueling the heroin epidemic. As patients grow tolerant to opioids, they are forced to search for stronger drugs, commit crimes, and ultimately die. Alternate solutions for pain management and regulation of opiates must be implemented in order to prevent the meaningless loss of lives.

There are many various kinds of prescription of pain relievers, which include: opioids, corticosteroids, antidepressants and anticonvulsants (anti-seizure medications). Among them I would like to focus on opioid medications and its side effects. Opioid medications are narcotic pain medications that contain natural poppy plant, synthetic opiates such as; methadone, fentanyl, tapentadol and tramadol, as well as the semi- synthetic opioids such as; oxycodone, hydrocodone, oxymorphone, hydromorphone and heroin. Opioid prescriptions are morphine (C17H19NO3), heroin (C21H23NO5), codeine (C18H21NO3) and thebaine (C19H21NO3). They are highly addictive substances are called opiates. Opioid medications have been used for hundreds and thousands of years to treat both pain and mental health problems. It is also use in a short-term pain after surgery. According to the survey in the past two decades, the prescription of opioid in the United States has been increased to the higher levels that is more than 600% (Paulozzi & Baldwin, 2012). However, that opioid medications are very dangerous to the patients’ respiratory system, other parts of the internal body and even can cause death. It should be only being use after wise discernment and with a great care.

Prior to 2000, nurses would routinely monitor a patient’s blood pressure, pulse, respirations and temperature: the four vital signs. After 2000, the Joint Commission on Accreditation of Healthcare Organizations added pain as the fifth vital sign and nurses were required to evaluate a patient’s pain level using a numeric scale of 0 to 10 (Florida Office of the Attorney General, 2012). This led to a flood of opioid based pain relievers hitting the market and an increase in physicians writing prescriptions for these medications. Previously opioids had been used for treatment of cancer related pain, but broadened to include management of chronic non cancer pain (Edlund, et al., 2014). Research by Edlund

Opioid medications are frequently prescribed for severe pain. Opioids includes the pain medications like oxycodone, hydrocodone, morphine, and fentanyl as well as the illegal drug heroin (American Society of Addiction Medication, 2016). Many people rely on these drugs to relieve their pain from surgery, active cancer, chronic pain and end of life care (WebMD, 2017). Studies from the 2012 National Health Interview show that over 11% of adults report having chronic pain (Dowell, Haegerich & Chou, 2016). The opioid epidemic is a significant issue for nursing on the main respect that there is currently a problem with over- prescribing of narcotics and the millions of people addicted to opioid medications

Statistically it is the older portion of the population that is most likely to take opioids as a means of controlling pain. However, in most of these cases the opioids are meant for long term chronic pain. When it comes to assessing opioid use for acute pain, it is ideal to focus on the 20 through 50 year old age range where there is increased instances of acute pain. Opioids are most often in the form of a tablet and are taken orally (Richeimer,2015); however, this study is aimed at discovering the possible positive benefits of administering a Remifentanil opioid transdermally and how this process will affect the

Opioid analgesics are gain large attention when examining the dangers from increasing prescription rates for two reasons. First, the prescription opioid drug class experienced one of the largest

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

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

Ketamine may be used for postoperative pain management. Low doses of ketamine reduce morphine use and nausea and vomiting after surgery. High quality evidence in acute pain is insufficient to determine if ketamine is useful in this

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).

Equipotent dose for ondansetron and ramosetron are unknown which makes it difficult to decide optimal dose. There are no established parameters to measure the severity of nausea, because it is a subjective symptoms and a valid visual analog scale or severity grade is needed. Except for intrathecal fentanyl, no other opioids were used in our study; perioperative opioid use is known to exaggerate PONV, the findings of our study should be used cautiously in patients whom opioids are used preoperatively. Our study was conducted in female patients undergoing gynecologic surgeries under spinal anesthesia. Extrapolation of our results to other patients having various surgeries under different methods of anesthesia requires further

The combined difference for 50% of the maximum pain relief between the control group and the intervention group was 7%, which gave an effect size of 0.07 without any side effects (Derry C.J. et al, 2014, p. 2). Although the effect size was quite small, due to the large quantity of participants, the results showed very promising evidence in favor of the addition of caffeine to the analgesics. The summary of the results showed that 48% of the intervention group agreed that they achieved 50% of the maximum pain

Pitakanen et al (1992) in a study evaluated the effect of adding fentanyl to prilocaine for IVRA and reported no significant benefit on duration of postoperative analgesia [10].