handy note cords for long forgotten hipp

1 Globally, nearly 313 million operations were performed in 2012, 2 whereas in the US an estimated 28 million inpatient surgical procedures and 48 million ambulatory surgeries were reported in 20, respectively. Surgery and anesthesia are critical health-care services that reduce the risk of death and disability among millions worldwide each year, and the need for these services is expected to continue to increase over the next decade. In clinical studies, oliceridine (TRV130), a novel μ-receptor G-protein pathway-selective modulator, produced rapid postoperative analgesia with reduced prevalence of adverse events versus morphine.

Several new opioids have been developed that modulate μ-receptor activity by selectively engaging intracellular pathways associated with analgesia and not those associated with adverse events, creating a wider therapeutic window than unselective conventional opioids. Conventional opioids remain the standard of care for the management of acute postoperative pain however, the risk of opioid-related adverse events can limit optimal dosing for analgesia, leading to poorly controlled acute postoperative pain. Although clinical findings are inconsistent, some studies of local anesthetics and nonopioid analgesics have suggested potential benefits as preventive interventions. More effective analgesic/anesthetic measures in the perioperative period are needed to prevent the progression to persistent pain. In addition, the presence and intensity of acute pain during or after surgery is predictive of the development of chronic pain.

Poorly controlled acute postoperative pain is associated with increased morbidity, functional and quality-of-life impairment, delayed recovery time, prolonged duration of opioid use, and higher health-care costs. Postoperative pain is not adequately managed in greater than 80% of patients in the US, although rates vary depending on such factors as type of surgery performed, analgesic/anesthetic intervention used, and time elapsed after surgery. This review provides an overview of the clinical issue of poorly controlled postoperative pain and therapeutic approaches that may help to address this common unresolved health-care challenge.

Handy note cords for long forgotten hipp