Ohio Response to COVID-19 and Its Impact on Interventional Pain Management Practices.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has drastically altered daily living and medical care for Ohio residents and the practice of medicine for the interventional pain management physician. As a state, Ohio tends to be demographically representative of the broader US population. OBJECTIVE: Reviewing the efforts deployed by Ohio to flatten the COVID-19 infection curve and reduce the spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important component of determining optimal procedures for mitigating the effects of the COVID-19 pandemic. METHODS: Over the course of several announcements and orders during the months of March and April, new policies were put into place to prevent COVID-19 transmission, which included efforts to facilitate social distancing and ensure the health care system could manage the number of COVID-19 cases at peak infection rate. Efforts directed toward medical providers included delay of elective procedures, expansion of telehealth options, and new temporary guidance for prescribing controlled substances. RESULTS: The Ohio COVID-19 containment approach resulted in a substantial reduction in COVID-19 cases compared with early models of disease spread, and the state has begun a phased reopening. Continued vigilance in applying social distancing and infection control measures will be a critical component of preventing or reducing the impact of a second wave of COVID-19 in Ohio. LIMITATIONS: A narrative review with paucity of literature.

Pharmacokinetic evaluation of hydrocodone/acetaminophen for pain management.

Hydrocodone/acetaminophen is not only the most commonly prescribed opioid in the United States but also the most common prescription medication written in America. Although original and early trials confirmed its ability to manage acute pain from surgery and musculoskeletal injury, it is perhaps more widely used today in the management of chronic pain. However, the opioid product was introduced for the management of moderate to moderately severe pain. Because it has been greatly abused as a prescription opioid medication, physicians need to be aware of the current knowledge regarding this analgesic drug. This review summarizes the current knowledge of the pharmacokinetics, pharmacodynamics, and metabolism of hydrocodone. Recent information regarding the possibility of hydrocodone as a prodrug for hydromorphone is discussed. The available clinical trials for the use of hydrocodone in the management of acute, chronic, and cancer pain are presented.