I’ve been thinking of traveling the US via van for several years now. I thought it would be awesome to get one for my 40th bday. Well, that’s almost 2 years from now. Then, I thought it would be a great idea to pull the trigger and purchase a van when we have our little one. Well, that time is quickly approaching as I’m in the 2nd trimester of the pregnancy. So, like with everything else I do…. there’s a ton of research!
Which size to get?
Who to go with?
My YouTube channel on Sprinter Vans
Awesome YouTuber for getting onboard with the van life: Hobo Ahle
Here’s what I’m leaning towards right now:
Sportsmobile seems to have an awesome option of the pop up top that could be an additional sleep area when we grow our family. That’s really the huge reason why we’re leaning towards Sportsmobile. We actually went to check out and do a factory tour of Outside Van and they were incredible!! If I hadn’t have found out about the popup top on the Sportsmobile, OSV would’ve definitely been our top pick.
We had a journal club where we discussed this article: Anesthesiology, May 2017; Clinical effectiveness and safety of intraoperative methadone in patients undergoing posterior spinal fusion surgery: a randomized, double-blinded, controlled trial.
- IV Methadone 0.2 mg/kg vs IV hydromorphone 2mg at surgical closure in 2+ level spinal fusion
- Decreased postop IV and opioid requirements and pain scores. Improved patient satisfaction
- Is there a pain service following these patients postoperatively?
- Exclusions: do you include OSA and BMI>45 patients?
- Is ETCO2 and PCA enough to combat respiratory depression on the floor?
- Are any discharged on the same day after receiving this dose — think total knees and single level lamis?
- Will this improve or worsen the opioid epidemic?
- Are surgeons on board with tackling pain multimodally for the benefit of the patient?
- For pain follow-up, are there psychiatry, homeopathy, palliative care, PT, holistic approaches for the patient?
Methadone Dose Conversion Guidelines
Intraop Lidocaine for postop pain
Intraop Ketamine for postop pain
Sys Rev 2014: Effectiveness of opioid substitution treatments for patients with opioid dependence: a systematic review and multiple treatment protocol.
Am j of Pub Health, Aug 2014. Determinants of Increased Opioid-Related Mortality in the United States and Canada, 1990–2013: A Systematic Review.
Br J Clin Pharmacol. 2014 Feb; 77(2): 272–284. Long term outcomes of pharmacological treatments for opioid dependence: does methadone still lead the pack?
PLoS One. 2014; 9(11): e112328. Methadone Induction in Primary Care for Opioid Dependence: A Pragmatic Randomized Trial (ANRS Methaville).
Curr Psychiatry Rev. 2014 May; 10(2): 156–167. Genetics of Opioid Dependence: A Review of the Genetic Contribution to Opioid Dependence.
Drug Alcohol Depend. 2016 Mar 1; 160: 112–118. Methadone, Buprenorphine and Preferences for Opioid Agonist Treatment: A Qualitative Analysis.
Croat Med J. 2013 Feb; 54(1): 42–48. Risk factors for fatal outcome in patients with opioid dependence treated with methadone in a family medicine setting in Croatia.
J Med Toxicol. 2016 Mar; 12(1): 58–63. Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”.
Syst Rev. 2014; 3: 45. Sex differences in outcomes of methadone maintenance treatment for opioid addiction: a systematic review protocol.
Continue reading “Methadone and Acute and Chronic Pain Management”