Pain and Opioid Abuse Vitals for June 2017

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We screened 811 studies on Pain and Opioid Abuse this month. These are the most important.

Vaginal delivery: remifentanil a safe, effective alternative to epidurals

Source: J Clin Anesth

  • In women undergoing a vaginal delivery, remifentanil (Ultiva) in patient-controlled analgesia may be a safe and effective alternative to the gold standard, epidural analgesia.
  • Alternatives to epidural analgesia are needed because of clinical contraindications or availability.


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Cochrane review: only weak evidence supports tramadol for cancer pain

Source: Cochrane Database Syst Rev

  • There is only limited, very low quality evidence favoring tramadol (Ultram) for cancer pain.
  • There are no studies of tramadol's analgesic effects in children with cancer.
  • The Cochrane review concludes that the current place of tramadol as step 2 in the World Health Organization (WHO) analgesic ladder is uncertain.
  • The WHO ladder serves as the gold standard for pain management.
  • Tramadol is a desirable opioid because of its low risk for abuse.

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Persistent pain linked to accelerated memory decline, increased risk for dementia in elderly

Source: JAMA Intern Med