Medicine and Health Sciences Commons^™

Symptomology Associated With In Utero Exposures To Polysubstance In An Appalachian Population., Will Lester, Lacey Andrews, Emma M. Nellhaus, Sara Murray, Sean Loudin, Todd H. Davies

Marshall Journal of Medicine

Neonatal abstinence syndrome (NAS) is seen as a very high rate at our institution in Huntington, West Virginia, and the majority of exposures are polysubstance in nature. Polysubstance can have different meaning for each region. At our institution, polysubstance is any combination of opioids, gabapentin, methamphetamine, cocaine, marijuana, benzodiazepines, nicotine or other neuroactive substances with 3-4 substances being the norm. Rapidly changing combinations of drug use and the lack of literature create a difficult situation for clinicians who are often reliant on treatment recommendations that lack references or conclusive data supporting the clinical approaches. Elucidating withdrawal symptoms consistent with in …

Reducing Postoperative Opioids After Minimally Invasive Hysterectomy With Enhanced Recovery, Kevin D. White, Shirin Azadi, Amanda Pauley, Dr. Brenda L Mitchell,, Nadim Bou Zgheib

Marshall Journal of Medicine

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Introduction:

We evaluated the efficacy of various strategies utilized for the control of postoperative pain after minimally invasive hysterectomy. The primary enhanced recovery after surgery (ERAS) protocol of interest utilized premedication (acetaminophen, celecoxib and pregabalin), then intraoperative subcutaneous liposomal bupivacaine followed by scheduled oral acetaminophen and ibuprofen postoperatively. Patients also had tramadol and oxycodone as needed for moderate or severe breakthrough pain, respectively.

Materials and Methods:

We conducted a retrospective cohort study that included all patients who underwent minimally invasive hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for both benign and oncologic indications over a 2-year period. We …

Overcoming America’S Opioid Epidemic Will Need Action Not Words, Rahul Gupta

Marshall Journal of Medicine

Opioids kill thousands of Americans each year. The opioid epidemic is the worst public health disaster in our nation’s history. The crisis touches countless communities, is a pivotal driver of the diminishing labor force and costs the country billions of dollars each year. West Virginia has the highest death rate due to drug overdose. It is important to identify the risk factors that can lead to overdose and seek science based and practical recommendations to tackle the problem.

Reducing Postoperative Opioids After Minimally Invasive Gynecologic Surgery With Multimodal Pain Control, Kevin D. White, William C. Wallace, Nadim Zgheib

Marshall Journal of Medicine

Introduction:

We evaluated the efficacy of a multimodal pain regimen that approaches pain control by utilizing different mechanisms of action. This novel protocol utilizing liposomal bupivacaine, acetaminophen, tramadol and oxycodone as needed in reducing the overall opioid use by patients after undergoing robotic-assisted total laparoscopic hysterectomy in an obese population that is heavily afflicted by the opioid epidemic.

Materials and Methods:

We conducted a retrospective study wherein a sample of 100 (50 multimodal group and 50 controls) were taken from 433 eligible cases conducted over a 1 year period. Patient medical records were evaluated for demographics, surgical characteristics, opioid type …

Academic Medicine Responds To The Opioid Crisis, John Prescott

Marshall Journal of Medicine

Opioid dependence has devastated communities across the nation particularly in rural states and academic medicine has responded in a variety of ways. Through its tripartite mission of education, research, and clinical care, creative solutions are being implanted. Medical schools and teaching hospitals are partnering with public health and law enforcement agencies, as well as local healthcare providers to address the clinical, social, and rehabilitative challenges. Academic medicine continues to adapt to the needs of the nation and teach, train, and prepare the next generation of physicians to be at their best when things are at their worst.