The White Mountain Institute

Dixon Lane-Meadow Creek, CA, United States

The White Mountain Institute

Dixon Lane-Meadow Creek, CA, United States
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White P.F.,Cedars Sinai Medical Center | White P.F.,The White Mountain Institute | Elvir-Lazo O.L.,Cedars Sinai Medical Center | Hernandez H.,Phoenix Systems
Journal of Clinical Anesthesia | Year: 2017

In a recent article from the Center for Disease Control, the authors addressed the current opioid epidemic in America and emphasized the importance of utilizing non-opioid analgesic alternatives to opioid medication for treating chronic pain. In cases where non-opioid analgesic drugs alone have failed to produce adequate pain relief, these authors suggested that non-pharmacologic therapies should also be considered. This Case Series describes a pilot study designed to evaluate a novel non-pharmacologic approach to treating long-standing (> 1 year) opioid dependency. The therapy involved the use of a high intensity cold laser device to treat three patients who had become addicted to prescription opioid-containing analgesic medication for treating chronic (residual) pain after a major operation. After receiving a series of 8–12 treatment sessions lasting 20–40 min to the painful surgical area over a 3–4 week period of time with the high intensity (42 W) Phoenix Thera-lase laser device, an FDA-approved Class IV cold laser, these patients were able to discontinue their use of all oral opioid-containing analgesic medications and resume their normal activities of daily living. At a follow-up evaluation 1–2 months after their last laser treatment, these patients reported that they have been able to control their pain with over-the-counter non-opioid analgesics and they have remained largely opioid-free. Further larger-scale studies are needed to verify these preliminary findings with this powerful cold laser in treating opioid-dependent patients. © 2017 Elsevier Inc.


Cao X.,Shenyang University | Cao X.,Cedars Sinai Medical Center | White P.F.,Cedars Sinai Medical Center | White P.F.,The White Mountain Institute | And 2 more authors.
Journal of Anesthesia | Year: 2017

Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients’ risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period. A combination of prophylactic antiemetic drugs should be administered to patients with moderate-to-high risk of developing PONV in order to facilitate the recovery process. Optimal management of perioperative pain using opioid-sparing multimodal analgesic techniques and preventing PONV using prophylactic antiemetics are key elements for achieving an enhanced recovery after surgery. Strategies that include reductions of the baseline risk (e.g., adequate hydration, use of opioid-sparing analgesic techniques) as well as a multimodal antiemetic regimen will improve the likelihood of preventing both PONV and PDNV. © 2017 Japanese Society of Anesthesiologists


Elvir-Lazo O.L.,Cedars Sinai Medical Center | White P.F.,University of Texas Southwestern Medical Center | White P.F.,Cedars Sinai Medical Center | White P.F.,Leonardo Foundation | And 2 more authors.
Anesthesiology Clinics | Year: 2010

Multimodal (or balanced) analgesia represents an increasingly popular approach to preventing postoperative pain. The approach involves administering a combination of opioid and nonopioid analgesics. Nonopioid analgesics are increasingly being used as adjuvants before, during, and after surgery to facilitate the recovery process after ambulatory surgery. Early studies evaluating approaches to facilitating the recovery process have demonstrated that the use of multimodal analgesic techniques can improve early recovery as well as other clinically meaningful outcomes after ambulatory surgery. The potential beneficial effects of local anesthetics, NSAIDs, and gabapentanioids in improving perioperative outcomes continue to be investigated. © 2010.

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