Abstract:
BACKGROUND:The use of opioids in non-cancer-related pain following skeletal trauma is controversial due to the presumed risk of dose escalation and dependence. We therefore examined the pattern of opioid prescriptions, that is, those actually dispensed, in patients with femoral shaft fractures. METHODS:We analysed data from the Swedish National Hospital Discharge Register and the Swedish Prescribed Drug Register between 2005 and 2008. RESULTS:We identified 1471 patients with isolated femoral shaft fractures. The median age was 75 (16-102) years and 56% were female. In this cohort, 891 patients (61%) received dispensed opioid prescriptions during a median follow-up of 20 months (interquartile range 11-32). In the age- and sex-matched comparison cohort (7339 individuals) without fracture, 25% had opioid prescriptions dispensed during the same period. The proportions of patients receiving opioid analgesics at 6 and 12 months after the fracture were 45% (95% CI 42-49) and 36% (32-39), respectively. The median daily morphine equivalent dose (MED) was between 15 and 17 mg 1-12 months post-fracture. After 3 months, less than 5% used prescription doses higher than 20 mg MED per day. Older age (≥ 70 compared with < 70 years) was a significant predictor of earlier discontinuation of opioid use (Hazard ratio [HR] 1.9). CONCLUSION:A notable proportion of patients continued to receive dispensed prescriptions for opioids for over 6 months (45%) and more than a third of them (36%) continued treatment for at least 12 months. However, the risk of dose escalation seems to be small in opioid-naïve patients.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Al Dabbagh Z,Jansson KÅ,Stiller CO,Montgomery S,Weiss RJdoi
10.1111/aas.12666subject
Has Abstractpub_date
2016-05-01 00:00:00pages
634-41issue
5eissn
0001-5172issn
1399-6576journal_volume
60pub_type
杂志文章abstract::Segmental epidural analgesia (T10-T12) was performed in 418 parturients, using a 4-6 ml dose of 0.5% bupivacaine, with or without adrenaline. Seventy per cent of parturients were primiparas and 30% had histories, or signs, of possible uteroplacental insufficiency. Our aim was to relieve pain during the long passive op...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1977.tb01207.x
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:We designed this study to compare the postoperative analgesic effects of intrathecal morphine and nalbuphine, the endpoints being onset and offset of action. METHODS:Geriatric patients scheduled for elective total hip replacement under continuous spinal anaesthesia were randomized to two double-blinded grou...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2000.440808.x
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:This retrospective study investigated the effect of nicotine dependence on required postoperative opioid administration in patients undergoing thoracic surgery. METHODS:The subjects consisted of 215 male patients (112 nonsmokers, 103 smokers) who underwent thoracic surgery and received postoperative patient...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12430
更新日期:2015-01-01 00:00:00
abstract::The adrenocortical, hyperglycemic, and hemodynamic responses to cholecystectomy or vagotomy were studied in 16 patients under halothane and N2O/O2 anesthesia. The patients were randomly divided into two groups: eight patients received naloxone in doses used clinically (2.5 microgram/kg i.v.) just before induction of a...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1981.tb01598.x
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Failed intubation remains one cause of anaesthesia-related morbidity and mortality. In a recent survey in Denmark, 20% of respondents reported preventable mishaps in airway management. METHODS:Assessment of the airway, and its documentation, as well as the availability of various equipment to manage a diffi...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.0001-5172.2004.0337.x
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Many studies demonstrate an association between brain damage and the extracellular release of catecholamines and amino acids during cerebral ischemia. While the clinical value of hypothermia during periods of compromised cerebral blood flow and oxygen delivery is well established, the role of anesthetic agen...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.1999.431004.x
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Hypophosphatemia has been associated with prolonged duration of respiratory failure and increased mortality in critically ill patients, but there is very limited evidence supporting the negative effects of low phosphate. We examined the association between hypophosphatemia at ICU admission and time to succes...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13136
更新日期:2018-04-23 00:00:00
abstract:BACKGROUND:We have previously proposed an equation derived from Fick's law and Lin's concept of effective blood concentration (EBC) to calculate the mixed venous blood concentration (MVBC) of isoflurane. Desflurane has a lower blood/air partition coefficient than isoflurane and, as such, promotes a faster induction and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.00887.x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:In mature animals with surfactant deficiency induced by lung lavage, the therapeutic effect of exogenous surfactant is enhanced by a lung recruitment maneuver. We then tested whether a lung recruitment maneuver at birth immediately before surfactant treatment would improve lung function also in preterm lambs...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2001.450811.x
更新日期:2001-09-01 00:00:00
abstract::Spinal anaesthesia with bupivacaine (22.5 mg) or with a glucose-containing solution of bupivacaine (20 mg) or tetracaine (15 mg) was given to 21 patients allocated randomly to these three groups. A urodynamic study was performed by CO2 cystometry. It consisted of recording of first sensation of bladder filling, sensat...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1985.tb02207.x
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate whether an initial post-operative lactate level is a predictor of mortality, need for peritoneal dialysis (PD), duration of intubation or length of stay (LOS) in the intensive care unit (ICU) in children undergoing cardiac surgery. METHOD:A retrospective, observa...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2011.02588.x
更新日期:2012-04-01 00:00:00
abstract::A prospective study of the arterial supply of the hand was carried out in 100 ICU patients after cannulation of the radial artery. Patency of the radial artery was checked using a reversed Allen's test and Doppler ultrasonic technique. Furthermore, radial artery angiography was carried out in 15 patients with suspect ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1986.tb02402.x
更新日期:1986-04-01 00:00:00
abstract::Liver cirrhosis and other chronic hepatic diseases are followed in a subset of affected patients by gas exchange abnormalities resulting from a syndrome called hepatopulmonary syndrome (HPS). The structural basis of this clinical entity is an alteration of pulmonary vasculature resulting in abnormal vasodilatation and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,评审
doi:10.1111/j.0001-5172.2004.00282.x
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Carbon monoxide poisoning is associated with high mortality and a substantial risk for brain damage in survivors. Evidence for acute brain dysfunction may be obtained by measuring concentrations of suitable biochemical markers. We hypothesized that increased serum concentrations of Neuron-specific enolase (N...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2004.00362.x
更新日期:2004-04-01 00:00:00
abstract::Dopamine seems theoretically to be a rationale choice when adrenergic support is needed to counter undesired cardiovascular depressant effects of isoflurane. Although the cardiovascular effects of isoflurane (ISO) and exogenous dopamine (DA) are well documented, there are no reports on their pharmacological interactio...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1995.tb04147.x
更新日期:1995-07-01 00:00:00
abstract::The effects of carnitine supplementation on fat and glucose metabolism and carnitine balance were studied in 12 preterm neonates receiving full or partial parenteral nutrition (PN) for 5 to 21 days. The gestational age ranged from 27 to 32 weeks and the birth weight from 790 to 2090 g. The neonates were assigned at ra...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1990.tb03132.x
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:The literature suggests that blood product transfusions have a negative impact on the survival of liver transplant patients. We investigated the impact of intraoperative blood product usage on the survival of liver transplantation patients being transplanted for hepatitis C-related end-stage liver disease. I...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2010.02313.x
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The incidence of Clostridium difficile-associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at a high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated int...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2008.01748.x
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg. METHODS:A randomised, double-blind, placebo-controlle...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aas.12333
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate the influence o...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2005.00758.x
更新日期:2005-11-01 00:00:00
abstract::Modern anaesthetic machines are equipped with several safety components to prevent delivery of hypoxic mixtures. However, such a technical development has increased the complexity of the equipment. We report a reconstructed anaesthetic machine in which a paramagnetic oxygen analyzer has provided the means to simplify ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1995.tb04121.x
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:We report a rare complication of radial arterial catheterization in a 74-year-old man who had undergone retroperitoneal surgery for an infra-renal aortic aneurysm. A right subclavian venous catheter and a right radial artery catheter were inserted for hemodynamic monitoring. RESULTS:The patient suddenly wen...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2004.00476.x
更新日期:2004-10-01 00:00:00
abstract::It can be shown that the assumption of an arbitrary value for VDphys/VT during IPPV can lead to unacceptable degrees of hypo- or hyperventilation. We investigated 33 adult patients scheduled for major non-thoracic surgery, to see if any simple tests could be used to predict VDphys/VT during anaesthesia/IPPV. Fifteen w...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1981.tb01606.x
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Infrarenal aortic cross-clamping causes renal vasoconstriction. Magnesium may protect against renal deterioration through its vasodilatory properties. METHODS:Thirty patients with normal preoperative renal function undergoing infrarenal aortic cross-clamping for elective aortic surgery received magnesium (4...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2000.00520.x
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Critically ill patients often receive fresh frozen plasma (FFP) if they have abnormal conventional coagulation tests. The aim of this study was to investigate the effect of FFP transfusion judged by a wide range of coagulation tests. METHODS:We included 30 critically ill patients receiving FFP and 30 critic...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12885
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The heart secretes natriuretic peptides (NPs) in response to myocardial stretch. Measuring NP concentrations is a helpful tool in guiding treatment. It has been suggested that sodium ion and hyperosmolality could affect NP excretion. If this is true, peri-operative NP measurements could be inconsistent when ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2009.01951.x
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13471
更新日期:2020-01-01 00:00:00
abstract::4-aminopyridine has earlier been shown to antagonize neuromuscular block and to release transmitters in CNS. In a study in man the drug was given intravenously at the end of anaesthesia in order to counteract muscle relaxation and possibly also anaesthesia. The effects were followed by clinical observations, intraarte...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1983.tb01911.x
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:We aimed to investigate the physiological mechanism and spatial distribution of increased physiological dead-space, an early marker of ARDS mortality, in the initial stages of ARDS. We hypothesized that: increased dead-space results from the spatial redistribution of pulmonary perfusion, not ventilation; suc...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13702
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Critically ill patients at southern latitudes have been shown to have low vitamin D levels that were associated with prolonged hospital stay. To our knowledge no studies have been conducted on vitamin D status amongst critically ill patients at high northern latitudes. Despite the Icelandic population tradit...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12748
更新日期:2016-10-01 00:00:00