Using Ultrasound Does Not Improve Shoulder Injection Results

Years ago, though they injected local in shoulder bursa, they injected the cortisone in the buttock and got the same results as injecting it it bursa. This study was ignored by people who wanted ultrasound to be better. Now, a randomized control trial did not find ultrasound versus landmark shoulder injection made any difference. Using US could be a lengthy procedure and I’m glad it is put to rest.
Continue reading “Using Ultrasound Does Not Improve Shoulder Injection Results”

Antidepressants May Lessen Benefits of Codeine or Hydromorphone

Codeine and hydromorphone need to be converted to an active form in the liver.  Anidepressants use the cytochrome CYP2D6 system in the liver and may cut down conversion and hence opioid effectiveness. This has been determined in post-operative pains in people on SSRI anti-depressants. However common antidepressants used in chronic pain –  amitriptyline, venlafaxine and duloxetine – all use the CYP2D6 system as well.

Continue reading “Antidepressants May Lessen Benefits of Codeine or Hydromorphone”