oxycodone/acetaminophen / Generic mfg. - LARVOL DELTA

Association between oxycodone-acetaminophen use and acute kidney injury in patients with lower extremity fractures: A retrospective cohort study. (PubMed, Medicine (Baltimore)) - "The use of oxycodone-acetaminophen within 48 hours of hospitalization may increase the risk of AKI in patients with lower extremity fractures. However, further randomized controlled trials are needed to elucidate this relationship."

Journal • Observational data • Retrospective data • Acute Kidney Injury • Critical care • Musculoskeletal Diseases • Nephrology • Orthopedics • Renal Disease

The effect of dexmedetomidine nasal spray combined with thoracic paravertebral nerve block on sleep and pain in patients with herpes zoster neuralgia (ChiCTR) - P4 | N=70 | Recruiting | Sponsor: Jiangsu Provincial People's Hospital; Jiangsu Provincial People's Hospital

New P4 trial • Herpes Zoster • Neuralgia • Pain • Varicella Zoster

Longitudinal Pain Medication Use Among US Older Adults After a Hip Fracture. (PubMed, J Am Med Dir Assoc) - "Most older adults received pain medication after hip fracture, and multimodal opioid-containing regimens were most common. Most individuals who received a gabapentinoid immediately after SNF admission were co-prescribed an opioid. These findings suggest an urgent need for closer medication management in SNFs to ensure adequate pain control after hip fracture while minimizing potentially harmful analgesic combinations."

Journal • Musculoskeletal Diseases • Orthopedics • Pain

Opioid Utilization in Post-Tonsillectomy Pediatric Patients (AAO-HNSF 2025) - "Patients were prescribed ibuprofen and acetaminophen with oxycodone for breakthrough pain... Our findings indicate some demographic factors may affect oxycodone use post-tonsillectomy. Moreover, many caregivers lack information on safe opioid disposal. Tonsillitis was associated with greater oxycodone usage."

Clinical • Infectious Disease • Otorhinolaryngology • Pediatrics

Identification of N-pyrrolidino protonitazene in suspect tablets encountered at an international mail facility. (PubMed, J Forensic Sci) - "One of the United States Food and Drug Administration's (FDA) National Forensic Chemistry Center (NFCC) international mail facility (IMF) satellite laboratories received suspect light blue, round tablets debossed with "PERCOCET 5" on one side and half score on the other side...This finding is alarming considering that this compound reportedly has 25 times the potency of fentanyl...Since first being identified in these tablets, N-pyrrolidino protonitazene has been encountered with increasing regularity by this laboratory in other tablets with different colors, shapes, and markings. This compound has also been identified in tablets containing other drug substances."

Journal

Does Liposomal Bupivacaine Reduce Postoperative Opioid Use in Tissue Expander Based Breast Reconstruction? (PSTM 2025) - "Opioid prescriptions were confirmed through the New York Prescription Monitoring Program (PMD) and converted into morphine equivalent doses (MED) for comparison...Patients prescribed multiple opioid types (e.g., Percocet + Tramadol or Percocet + Oxycodone) had higher MED and total opioid prescriptions than those prescribed a single opioid type (p<0.05), emphasizing the impact of combination opioid therapy on overall consumption... The use of Exparel regional blocks significantly reduces postoperative opioid consumption and total opioid prescriptions following tissue expander-based breast reconstruction compared to Marcaine. This is likely due to Exparel's extended analgesic effect during the critical early postoperative period, when pain is most severe. These findings align with previous studies demonstrating the efficacy of Exparel in reducing opioid use across various surgical procedures."

Addiction (Opioid and Alcohol) • Anesthesia • Constipation • Gastroenterology • Gastrointestinal Disorder

Comment on: Evaluation of the analgesic effect of a combination of oral acetaminophen and oxycodone after extracorporeal shock wave lithotripsy (SWL). (PubMed, Urologia) - No abstract available

Journal • Pain

Assessing Clinician Compliance with The Office of the Inspector General (OIG) Recommended Follow-Up for Long-Term Opioid Therapy (PAINWeek 2025) - "The most common opioid initiated for long-term opioid therapy was tramadol (36.4%), followed by hydrocodone/acetaminophen (19.3%), oxycodone (18.6%), and buprenorphine (16.4%). A total of 159 patients were initially identified for review based on meeting enrollment criteria for chronic opioid therapy between July 1, 2022 to July 1, 2024. Of those patients, 5 were excluded due to off-label opioid use disorder treatment or death prior to the end of the 90-day follow-up period. Additionally, 14 patients were excluded as the prescription for the long-term opioid therapy originated from a community care provider and therefore risk mitigation strategies were not required by a VA provider."

Clinical • Compliance • Back Pain • CNS Disorders • Musculoskeletal Pain • Pain • Substance Abuse

No-PAIN: NSAID Use After Robotic Partial Nephrectomy (clinicaltrials.gov) - P2 | N=110 | Recruiting | Sponsor: University of Miami | Trial completion date: Sep 2025 ➔ Sep 2026 | Trial primary completion date: Sep 2025 ➔ Sep 2026

Trial completion date • Trial primary completion date • Genito-urinary Cancer • Kidney Cancer • Oncology • Pain • Renal Cell Carcinoma • Solid Tumor

Prescription Trends by Orthopedic Surgery Provider: Review of the Medicare Part D Prescribers - by Provider and Drug, 2013-2021. (PubMed, Orthopedics) - "In line with national guidelines, claims for NSAIDs are increasing and claims for opioid pain medications and AOMs are decreasing. Claims for outpatient antibiotics are increasing, which is of significant concern, given renewed focus on antibiotic stewardship."

Journal • Medicare • Reimbursement • Review • US reimbursement • Orthopedics • Pain

Pain Relief After Trapeziectomy: Ibuprofen & Acetaminophen Versus Oxycodone (clinicaltrials.gov) - P2 | N=121 | Recruiting | Sponsor: Stanford University | Trial completion date: Aug 2026 ➔ Aug 2027 | Trial primary completion date: Feb 2026 ➔ Feb 2027

Trial completion date • Trial primary completion date • Immunology • Osteoarthritis • Pain • Rheumatology

Outcomes After Implementation of an Enhanced Recovery Protocol for Minimally Invasive Repair of Pectus Excavatum. (PubMed, Am Surg) - "Use of narcotic patient-controlled analgesia (PCA) was nearly halved after ERAS implementation (50.0% vs. 97.2%), and total oxycodone, Percocet, and Dilaudid dosages were significantly reduced. Implementation of an ERAS protocol was associated with significant reductions in overall hospital length of stay, ICU utilization, and inpatient opioid consumption following Nuss repair of pectus excavatum. These changes in post-op management are expected to reduce costs and promote earlier return to school and activities."

Journal • Critical care • Pain • Pediatrics

Trial to Assess the Efficacy and Safety During Convective Radiofrequency Water Vapor Thermal Therapy (REZUM) for Benign Prostate Hyperplasia (clinicaltrials.gov) - P3 | N=48 | Not yet recruiting | Sponsor: University of Manitoba

Head-to-Head • New P3 trial • Anesthesia • Benign Prostatic Hyperplasia

Outpatient hybrid intracavitary-interstitial brachytherapy for cervical cancer with minimal sedation in a freestanding setting. (PubMed, Gynecol Oncol Rep) - "The patients were treated using minimal sedation (oral lorazepam and oxycodone/acetaminophen). Combining intracavitary and interstitial implants using a hybrid applicator appears to be feasible, efficient and safe in an outpatient freestanding clinic. Further studies are warranted."

Journal • Anesthesia • Cervical Cancer • Oncology • Solid Tumor

Therapeutic Efficacy of Oxycodone/Acetaminophen Combined with Bisphosphonates in Bone Metastasis-Induced Cancer Pain and Its Modulation of Pain-Related Mediators (ChiCTR) - P4 | N=60 | Not yet recruiting | Sponsor: Quzhou People Hospital; Quzhou People Hospital

New P4 trial • Oncology • Pain • Solid Tumor

A RARE CASE OF ACUTE ON CHRONIC PAIN IN SETTING OF LUMBAR SPINAL STENOSIS AND MULTIPLE SCLEROSIS (ASRA-SPRING 2025) - "Here, we present a case of lumbar spinal stenosis and associated radiculopathy in a patient with MS causing diagnostic difficulty CASE PRESENTATION A 47-year-old female with history of multiple sclerosis (diagnosed in 2003) on Ozanimod, L5-S1 spinal stenosis on cyclobenzaprine, tizanidine, and gabapentin, prior radiculopathy and myofascial pain - having received multiple trigger point injections with lidocaine over bilateral cervicothoracic paraspinals and prior TFESI (Transforaminal Lumbar Epidural Steroid Injections) in 2015, presented to the emergency department in 2024 with shooting pain starting at her right hip progressing down the back of her leg with associated numbness on the right ankle and foot...She was started on a multimodal pain regimen including oxycodone 5 mg, acetaminophen 975 mg, ibuprofen 800 mg, lidocaine patch, gabapentin 600 mg, cyclobenzaprine 10 mg, duloxetine 30 mg and hydromorphone for breakthrough pain...This case highlights the importance of..."

Clinical • CNS Disorders • Inflammation • Multiple Sclerosis • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain

PERIOPERATIVE REGIONAL ANESTHESIA FOR A RARE CASE OF INTERSCAPULOTHORACIC "FOREQUARTER" AMPUTATION IN A PATIENT WITH OSTEOSARCOMA (ASRA-SPRING 2025) - "Pain and swelling continued to worsen during this time, requiring escalating doses of morphine ER and oxycodone-acetaminophen, and ultimately leading to hospital admission for pain management and expedited initiation of chemotherapy...At the time of procedure, his pain regimen included a fentanyl PCA with basal rate 100mcg per hour and bolus dose of 50 mcg q10min with a 4-hour limit of 640mcg, 100mcg IV fentanyl q4hr PRN for breakthrough pain, duloxetine 60mg daily, acetaminophen 1g q8hr, dexamethasone 4mg daily, and lidocaine patches...Intraoperatively, a ketamine infusion at 0.25mcg/kg/hr was utilized for analgesia, but no long-acting narcotics. In the post-anesthesia care unit, hereceived four 25mcg doses of fentanyl and two 0.5mg doses of hydromorphone for pain scores rating as 10/10 prior to restarting his PCA as above...Discussion There are several case reports of peripheral nerve catheters utilized for pain management for forequarter amputations, but to our..."

Clinical • Anemia • Anesthesia • Hematological Disorders • Infectious Disease • Musculoskeletal Diseases • Musculoskeletal Pain • Oncology • Orthopedics • Osteosarcoma • Pain • Rare Diseases • Sarcoma • Solid Tumor

ANTERIOR SUPRASCAPULAR NERVE BLOCK FOR REVISION TOTAL SHOULDER ARTHROPLASTY IN A PATIENT WITH SIGNIFICANT RESPIRATORY COMPROMISE (ASRA-SPRING 2025) - "CASE REPORTOur patient is a 66-year-old female with uncontrolled hypertension, COPD on 4L O2 prn nightly, current smoker (11.5 pack-years), history of pulmonary embolism s/p apixaban treatment, CVA with residual left-sided weakness, bipolar II disorder, and chronic pain taking tramadol, pregabalin, and oxycodone-acetaminophen...We connected standard ASA monitors, performed time-out, and premedicated with midazolam 2mg...We anesthetized the skin, advanced a 50mm needle near the suprascapular nerve under ultrasound guidance, deposited 10mL of 0.5% ropivacaine, and confirmed local anesthetic spread around the suprascapular nerve (Figure 1)...She was discharged on POD 4 without complication. We believe our decision to place an ASSB for I&D and revision total shoulder arthroplasty achieved our goal to provide safe and satisfactory anesthetic care to our medically complex patient."

Clinical • Anesthesia • Bipolar Disorder • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Hypertension • Immunology • Infectious Disease • Musculoskeletal Pain • Orthopedics • Pain • Psychiatry • Pulmonary Embolism • Respiratory Diseases

QUADRATUS LUMBORUM BLOCK WITH LIPOSOMAL BUPIVACAINE FOR KIDNEY TRANSPLANTATION IN TWO PEDIATRIC PATIENTS (ASRA-SPRING 2025) - "The off-label use of liposomal bupivacaine (EXPAREL, Pacira BioSciences, Inc.) was approved by the surgeon and pharmacy leadership, and the patients’ guardians provided written consent for its use...Intraoperative analgesics included intravenous fentanyl, methadone, acetaminophen, and dexmedetomidine as presented in Table 2...Analgesics in the postop phase included a hydromorphone patient-controlled analgesia (PCA) pump, oxycodone, and acetaminophen (Table 2)...Table 3 presents the Numerical Rating Score on the pain scale (0-10) and oral morphine milliequivalents (MME)...However, the duration of a single injection block with bupivacaine or ropivacaine is short-lived...However, our patients had excellent pain control for the first 4 days postoperatively and adequate pain control for the entire hospital stay with minimal opioid administration, low pain scores, and high satisfaction with the pain control. More studies are required to investigate the pharmacokinetics of..."

Clinical • Anesthesia • Pain • Pediatrics • Transplantation

MANAGEMENT OF A PATIENT WITH VENTRICULAR ASSIST DEVICE (VAD) USING REGIONAL BLOCK AS AN ADJUNCT FOR SHOULDER REPLACEMENT SURGERY (ASRA-SPRING 2025) - "A pre-induction arterial line was placed, followed by an ultrasound-guided interscalene block using 15 mL of 0.5% ropivacaine and 2 mg of preservative-free dexamethasone...Intraoperative opioids were limited to 100 mcg of fentanyl at induction...This included intravenous hydromorphone, oralacetaminophen, and oxycodone...Hemodynamic stability in VAD patients is crucial to avoid pump failure and intraoperative morbidity and mortality. The beneficial role of regional anesthesia in hemodynamic management warrants further investigation into its application for non-cardiac surgery and its long-term impact on perioperative outcomes in VAD patients."

Clinical • Surgery • Addiction (Opioid and Alcohol) • Anemia • Anesthesia • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Depression • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Hypertension • Orthopedics • Pain

CLINICAL INDICATIONS FOR A PREOPERATIVE PAIN CONSULTATION: A REVIEW OF REGISTRY CASES AT AN ORTHOPEDIC SPECIALTY HOSPITAL (ASRA-SPRING 2025) - "In patients with chronic opioid use, 78.6% (n=611) had an active opioid at surgical admission, with 80.4% (n=491) taking a combined opioid-NSAID/acetaminophen tablet, oxycodone, or tramadol, and approximately 11.3% (n=69) on buprenorphine, buprenorphine-naloxone or methadone (table 2). Though most patients had an active, short-acting opioid prescription at surgical admission, approximately 11% were on medication assisted treatment. Continued granular data collection through our registry[5] will enable the study of interindividual pain differences in patients with complex pain before and after surgery."

Clinical • Review • Anesthesia • CNS Disorders • Depression • Orthopedics • Pain • Psychiatry

Elite Pharmaceuticals Announces Commercial Launch of Oxycodone and Acetaminophen Tablets (Elite Pharma Press Release) - "Elite Pharmaceuticals...announced that the company has launched Elite's generic version of Percocet (oxycodone hydrochloride and acetaminophen tablets, USP CII) 5mg/325mg, 7.5mg/325mg and 10mg/325mg tablets. Oxycodone HCl and acetaminophen is indicated for the relief of moderate to moderately severe pain."

Generic launch • Pain

Opioid Drug Interaction Study (clinicaltrials.gov) - P1/2 | N=25 | Recruiting | Sponsor: Shanna Babalonis, PhD | Trial completion date: Jun 2028 ➔ Jun 2029 | Trial primary completion date: Jan 2028 ➔ Jan 2029

Trial completion date • Trial primary completion date

Bioequivalence study of acetaminophen and oxycodone tablets in humans (ChiCTR) - P1 | N=68 | Completed | Sponsor: Hebei General Hospital; HEBEI AOXING GROUP PHARMACEUTICAL CO..LTD

New P1 trial

Supracondylar Post-Operative Pain Study (clinicaltrials.gov) - P4 | N=90 | Recruiting | Sponsor: University of California, Los Angeles | Trial completion date: Jun 2025 ➔ Dec 2027 | Trial primary completion date: Dec 2024 ➔ Dec 2027

Trial completion date • Trial primary completion date • Musculoskeletal Diseases • Orthopedics • Pain • Pediatrics