Examinando por Materia "Opioid"

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    Ítem
    The Impact of the Legalization of Medical Marijuana in the Opioid Epidemic
    (Universidad EAFIT, 2022) Plata Rúa, Alejandra; Acosta Mejía, Camilo Andrés
    We study the effects of marijuana legalization on demand for opioids in the United states. We tackle this question using transaction level data on the purchases of opioids by all pharmacies across the US between 2006 and 2012, together with a difference-in-discontinuity research design across two pairs of states: Michigan and Indiana, and New Mexico and Texas. We show that, on average, the legalization of marijuana has lead to a reduction in the purchases of opioids. However, this negative effects is mainly driven by a reduction along the Michigan-Indiana border, while there has been an increase along the New Mexico-Texas border. This ambiguous effects, which mimics the contradictory evidence found in the literature, suggest the existence of important heterogeneous effects and the need for further investigating such differences.
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    Ítem
    Total intravenous anesthesia in a closed loop system: Report of the first case in Colombia
    (Sociedad Colombiana de Anestesiología y Reanimación, 2013-10-01) Oquendo, F.J.G.; Arroyave, F.D.C.; Fernández, J.M.; Grisales, A.G.; Oquendo, F.J.G.; Arroyave, F.D.C.; Fernández, J.M.; Grisales, A.G.; Universidad EAFIT. Departamento de Ingeniería de Producción; Grupo en Tecnologías para la Producción
    Total intravenous anesthesia is a widely used technique that relies on the use of intravenous anesthetics, propofol being the most frequently used and studied. At present, there are pharmaceutical and pharmacokinetic tools that are used to generate mathematical models to ensure the safe and moderately effective use of this technique. However, the depth of anesthesia is determined purely on the clinical findings and this requires neurological monitoring such as the bi-spectral index (BIS) in order to correlate the data derived from the pharmacokinetic models used for the administration of the anesthetic with the determination of its desired clinical effect. We designed an operating system for automated control of the propofol infusion that provides feedback on the basis of the data generated by the BIS monitor. The system is programmed to increase or decrease the propofol infusion within a specific BIS range and, consequently, in accordance with the needs of the individual patient. We describe anesthetic management using this technique in a female patient taken to surgery for prosthetic mammary implantation under general anesthesia at the University Hospital. An intraoperative record was generated including the depth of anesthesia and its action on propofol concentration at the effective site using the automated administration and control system. We concluded that the use of closed-loop total intravenous anesthesia under neurologic monitoring is the next step in the evolution of this technique. It is less reliant on the pharmacokinetic models available at present, and is better suited to adapt to the specific needs of individual patients and to the type of surgical intervention. © 2012 Sociedad Colombiana de Anestesiología y Reanimación. Published by Elsevier España, S.L. All rights reserved.