The purpose of this study is to look at a standardized methadone-based enhanced recovery after surgery protocol following pediatric cardiac surgery. This study will consist of randomly assigning children to receive the methadone-based recovery procedures or to receive current standard of care recovery procedures. Randomly assigning means that there is a 50/50 chance, like a coin flip, of being assigned to either research group.

Start Date01 Jan 2025

Sponsor / Collaborator

University of Pittsburgh

[+1]

NCT06626503 / Not yet recruitingPhase 2IIT

Prospective Randomized Evaluation of Analgesia for Spine Fusion Elective Surgery in Children

The purpose of this study is to look at a standardized methadone-based enhanced recovery after surgery protocol following pediatric spinal surgery. This study will consist of randomly assigning children to receive the methadone-based recovery procedures or to receive current standard of care recovery procedures. Randomly assigning means that there is a 50/50 chance, like a coin flip, of being assigned to either research group.

Start Date01 Jan 2025

Sponsor / Collaborator

University of Pittsburgh

[+1]

NCT06720415 / Not yet recruitingPhase 4IIT

Comparison of Oral and Intravenous Methadone for Analgesia in Cardiac Surgery

The purpose of this study is to compare the effects of administration of oral methadone preoperatively and intravenous methadone upon induction of general anesthesia on postoperative pain for patients undergoing elective cardiac surgery.

Start Date15 Dec 2024

Sponsor / Collaborator

Mayo Clinic

100 Clinical Results associated with Methadone Hydrochloride

100 Translational Medicine associated with Methadone Hydrochloride

100 Patents (Medical) associated with Methadone Hydrochloride

15,159

Literatures (Medical) associated with Methadone Hydrochloride

01 Feb 2025·Journal of substance use and addiction treatment

Development of a brief stigma and perceptions questionnaire for pharmacists: An exploratory factor analysis approach in New York state counties enrolled in the healing communities study

Article

Author: David, James L. ; Kim, Erin ; Nunes, Edward ; McCrimmon, Tara ; Xu, Jiaxin ; Wu, Elwin ; Lounsbury, David W. ; Sabounchi, Nasim S. ; Gutnick, Damara ; Gruss, Dawn ; Sabounchi, Nasim S ; Gatanaga, Ohshue S. ; Levin, Frances ; Bhuiyan, Jennifer ; Gilbert, Louisa ; Cervantes, Melissa ; El-Bassel, Nabila ; Balise, Raymond ; Rodriguez, Sandra ; Angerame, Angelo ; Huang, Terry ; Feaster, Daniel ; Rodgers, Emma ; Campbell, Aimee ; Lounsbury, David W ; Edwards, Kevonyah ; Dsouza, Nishita ; David, James L ; Gatanaga, Ohshue S ; Goddard-Eckrich, Dawn ; Grealis, Kyle ; Hunt, Timothy

INTRODUCTION:

Little is known about how pharmacists' attitudes and stigma toward naloxone and Medication for opioid use disorder (MOUD) influence effective linkage to treatment. We examine the psychometrics of a new Pharmacist Opioid Use Disorder Perceptions Questionnaire (P-OUDP-Q), a multidimensional measure to examine pharmacists' stigma and perceptions related to MOUD in the New York State (NYS) site of the HEALing Communities Study.

METHODS:

The study recruited a sample of 324 pharmacists from 16 counties in NYS between January and June 2022. A 74-item questionnaire assessed pharmacists' familiarity with opioid-related medications, protocols, policies and attitudes regarding their role, confidence, and beliefs centered around delivery of MOUD and naloxone in the community. Exploratory factor analysis assessed individual and community-level factors associated with four underlying constructs. Factor scores were compared across the demographic predictors. Variables factor loadings <0.4 were eliminated from the factor analysis and the process was reiterated.

RESULTS:

Eighty-six percent (n = 280) of the pharmacists were white. A little over half, 57 % (n = 186), were female, 35 % (n = 113) were 30-35 years old. The mean number of years practicing (SD) was 18 (SD: 13). Exploratory factor analysis identified four underlying constructs: (1) practice confidence, (2) practice familiarity, (3) practice attitudes, and (4) methadone attitudes. Statistically significant (p < .05) mean factor scale score differences by race were observed for practice familiarity (white reporting higher than non-white); by pharmacy size for practice familiarity (across all groups; non-significant Tukey post-hoc) and practice attitudes (hospital/clinic greater than big chain pharmacies); by gender (males greater than females) for practice familiarity and methadone attitudes; by poverty quartile for practice attitudes (lowest less than highest quartile); and urban versus rural pharmacist county setting for practice familiarity (rural greater than urban).

CONCLUSIONS:

Findings show the P-OUDP-Q is a concise measure of pharmacists' perceptions of their role in dispensing MOUD and naloxone, including distinct "stigma" dimensions, which is valuable for use with pharmacists in communities highly impacted by the opioid epidemic. The development and validation of a reliable measure to assess pharmacists' perceptions of stigma and barriers represents a valuable contribution to the field, to inform the design/implementation of targeted interventions and support systems.

01 Feb 2025·ADDICTIVE BEHAVIORS

Exposure to Bupropion-SR vs. Placebo is associated with reductions in smoking among persons receiving methadone with no stated interest in smoking cessation

Article

Author: Dunn, Kelly E ; Umbricht, Annie ; Stitzer, Maxine L. ; Ware, Orrin D. ; Ware, Orrin D ; Stitzer, Maxine L ; Dunn, Kelly E.

Smoking is prevalent among individuals receiving methadone treatment. Reducing smoking among this population is needed as smoking is a leading cause of morbidity and preventable death. Smoking cessation interventions for persons receiving medication for opioid use disorder have yielded small changes in abstinence. Bupropion-SR was developed as an anti-depressant medication and is a first-line medication for smoking cessation. There is limited research on the effectiveness of bupropion-SR on smoking cessation among individuals receiving medication for opioid use disorder. This study is a secondary analysis of N = 72 adults enrolled in methadone treatment who endorsed smoking cigarettes. Participants were randomized to receive bupropion-SR 150 mg twice-daily (n = 35) or placebo (n = 37) in the primary study that examined bupropion-SR on cocaine use outcomes over a 30-weeks. Mixed model analyses examined secondary changes in self-reported cigarettes smoked, a self-reported measure of nicotine dependence, and quantitative urinary cotinine values. The longitudinal analysis of self-reported daily cigarettes identified no main effects of group and week however a significant interaction between group and week revealed that persons receiving bupropion-SR group reported less smoking early in the intervention. Longitudinal evaluation of changes in urinary cotinine revealed a significant main effect of week but no main effect of group or group x week interaction. Data suggest that bupropion-SR significantly decreased the number of self-reported cigarettes smoked relative to placebo and reduced nicotine dependence severity by the end of the study. Follow-up studies are needed as these decreases were not identified throughout the full study period or at termination.

01 Jan 2025·Journal of neurosurgical anesthesiology

Perioperative Methadone for Spine Surgery: A Scoping Review

Article

Author: Pereira, Sergio M. ; Goel, Akash ; Velazquez, Ahida A. ; Ma, Kan ; Bebawy, John F. ; Sinedino, Bruno Erick ; Nunn, Kieran P.

Complex spine surgery is associated with significant acute postoperative pain. Methadone possesses pharmacological properties that make it an attractive analgesic modality for major surgeries. This scoping review aimed to summarize the evidence for the perioperative use of methadone in adults undergoing complex spine surgery. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search was performed using MEDLINE, CINAHL, Cochrane Library, Scopus, Embase, and Joanna Briggs between January 1946 and April 2023. The initial search identified 317 citations, of which 12 met the criteria for inclusion in the review. There was significant heterogeneity in the doses, routes of administration, and timing of perioperative methadone administration in the included studies. On the basis of the available literature, methadone has been associated with reduced postoperative pain scores and reduced postoperative opioid consumption. Though safety concerns have been raised by observational studies, these have not been confirmed by prospective randomized studies. Further research is required to explore optimal methadone dosing regimens, the potential synergistic relationships between methadone and other pharmacological adjuncts, as well as the potential long-term antinociceptive benefits of perioperative methadone administration.

News (Medical) associated with Methadone Hydrochloride

31 Oct 2024

·www.prnewswire.com

B.More Collaborator, Dr. Michael Bogenschutz, Awarded $15 Million NIDA Grant for Landmark Psilocybin Study in Opioid Use Disorder

GREENWICH, Conn. , Oct. 31, 2024 /PRNewswire/ -- B.More Inc., a 501(c)(3) non-profit, clinical-stage biopharmaceutical company dedicated to the development of psychedelic medicines for substance abuse disorders, is pleased to announce that its collaborator, Dr. Michael Bogenschutz, Director of the NYU Langone Center for Psychedelic Medicine, has been awarded a grant of $3 million per year for a total of 5 years dependent on progress during the first 2 years, from the National Institute of Drug Abuse (NIDA). This funding will support the first clinical trial to evaluate psilocybin's efficacy as a treatment for Opioid Use Disorder (OUD). If successful, the trial will provide the basis for a full-scale drug development program aimed at achieving FDA approval for psilocybin as a treatment for OUD. The NIDA-funded, double-blind, multi-site, phase 2 randomized controlled clinical trial will assess psilocybin's therapeutic potential to reduce opioid cravings and improve emotional well-being in individuals struggling with OUD but who continue to use non-prescribed opioids despite adherence to methadone treatment. Conducted across four treatment centers in New York and New Mexico, the trial plans to enroll 240 participants, including OUD patients with co-occurring substance use and psychiatric disorders. With participants drawn predominantly from low-income minority populations, the study marks a significant shift toward diversity in psychedelic research, addressing a critical knowledge gap with respect to underrepresented groups. Participants will receive manualized, non-directive clinical support and will be randomly assigned to receive a single administration of psilocybin 30 mg (high dose), psilocybin 20 mg (medium dose), or psilocybin 1 mg (low-dose control condition). Weekly urine drug screens and continuous self-report of opioid and other drug use will be collected for 24 weeks after psilocybin administration, along with measures probing OUD-related neuropsychopathology and functional outcomes. Unlike previously reported psychedelic trials, the study will include prospective assessment of pre-randomized patient expectancies along with post-treatment patient beliefs regarding treatment assignment, providing data for modelling the contribution of expectancy effects on reported outcomes. B.More, which will license the trial data for commercial development, will supply cGMP psilocybin for the study and will also fund other support for the goal of an eventual New Drug Application (NDA). "This trial is a vital step toward understanding psilocybin's therapeutic potential in Opioid Use Disorder," said Carey Turnbull, Co-founder, and CEO of B.More Inc. "In working with Dr. Bogenschutz, our goal is to create a treatment pathway that's accessible, effective, and safe, opening new avenues for psychedelic-assisted therapy as an FDA-approved tool in the fight against addiction. This NIDA funded OUD trial taking place in substance abuse treatment centers pairs nicely with NYU's previously announced NIH funded alcohol use disorder trial being conducted within the Silver Hill rehab center, adding to their expertise in the treatment of substance abuse using psilocybin." According to Dr. Bogenschutz, "In addition to providing a rigorous test of safety and efficacy, this trial will provide information regarding the feasibility of implementing psilocybin-assisted treatment for OUD within the existing system of care. If psilocybin is found to be safe and effective, this model would provide a new option for OUD patients who are receiving treatment but continue to struggle with illicit opioid use." About B.More Founded in 2017 by Carey and Claudia Turnbull, B.More is a 501(c)(3) non-profit, clinical-stage biopharmaceutical company with a mission to develop better treatment options for those struggling with alcohol use disorder and other substance use disorders. With researchers at the NYU Grossman School of Medicine, B.More is advancing clinical research to help these individuals, and their loved ones, live a better tomorrow. For more information, please visit Logo - SOURCE B.More Inc. WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Phase 2

24 Oct 2024

·www.prnewswire.com

Montana: A Trailblazer in Eliminating Regulatory Barriers for Opioid Use Disorder Treatment, According to Community Medical Services

HELENA, Mont., Oct. 24, 2024 /PRNewswire/ -- When the Substance Abuse and Mental Health Services Administration (SAMHSA) updated their recommendations governing Opioid Treatment Programs (OTPs) in April 2024, Montana was among the first to implement significant changes for OTPs in the state. Community Medical Services (CMS) currently provides care to Montana residents at 4 clinics, (Billings, Bozeman, Kalispell and Missoula), and has been working to adjust their clinical guidance to institute these changes aimed at improving patient safety and retention in treatment programs. This is a crucial step forward in addressing the opioid epidemic, providing more effective care for individuals struggling with opioid use disorder. Extended Take-Home Doses Under the new rules, patients are no longer required to come to a clinic at the same frequency as they have historically needed to. Medical providers can determine the appropriate number of take-home doses based on individual patient needs and criteria, including: Absence of active substance use disorders or other health conditions that increase the risk of patient harm Regular attendance for supervised medication administration Absence of serious behavioral problems Absence of known recent diversion activity Safe transportation and storage of take-home medication Higher Initial Dosing The initial dose of methadone, which was historically capped on the first day, can now be titrated more quickly at the medical provider's discretion, allowing patients with higher opioid tolerance to get to a therapeutic dose more quickly. This change acknowledges the varying levels of opioid tolerance among patients, exacerbated by the increased presence of fentanyl in the illicit drug supply, and enables medical providers to tailor treatment to individual needs. Drug Screens The presence of unprescribed amphetamine or cocaine on drug screen results will no longer be the sole limiting factor to requiring patients to not have to come into clinics daily, unless it increases the risk of overdose. This change recognizes that patients with opioid use disorder may also struggle with other substance use disorders and requires medical providers to assess each patient's unique situation. Conclusion The SAMHSA Final Rule changes mark a crucial step forward in enhancing Opioid Treatment Programs in Montana. By providing more flexible and individualized treatment options, these changes aim to improve patient safety and retention, decrease daily patient volumes at clinics, and ultimately support individuals in their journey towards recovery. How CMS is Implementing SAMHSA's Changes At its 4 clinics in Montana, CMS has proactively implemented the SAMHSA Final Rule changes. Our approach focuses on balancing patient safety with reducing barriers to treatment, ensuring that any changes benefit our patients and their recovery outcomes. Triweekly dosing—allowing patients to come to the clinic only three times per week—has become the new standard. This means that most patients, even those who might test positive for stimulants or miss some clinic days, are not required to visit the clinic more than three times a week. For patients who meet certain stability criteria, the option to advance to weekly clinic visits is available after just two weeks of triweekly dosing. This provides immense relief to patients who previously struggled to balance daily trips to the clinic with their other responsibilities, such as work or family. Visit the CMS blog on our website for a complete review by our Chief Science Officer, Dr. Robert Sherrick, of how we are taking an active step toward implementing these changes and seeing early positive results Media Contact: John Koch- Director Public Relations [email protected] 2827 Fort Missoula Rd, Missoula, MT 59804 8707 Jackrabbit Ln Suite D, Belgrade, MT 59714 2415 S Catlin St, Missoula, MT 59801 795 Sunset Blvd F, Kalispell, MT 59901 2040 Rosebud Dr, Billings, MT 59102 2827 Fort Missoula Rd, Missoula, MT 59804 SOURCE Community Medical Services WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

22 Oct 2024

·www.prnewswire.com

Sonara Health Continues Expansion of Remote Methadone Treatment With $2.5M Grant From NIDA

$2.5 million dollar NIDA grant will fund second phase of study to evaluate treatment retention, cost and effectiveness of Sonara's remote methadone treatment DALLAS, Oct. 22, 2024 /PRNewswire/ -- Sonara Health, a leading innovator in remote methadone treatment, is capping off a year of significant growth with a $2.5M grant from the National Institute on Drug Abuse (NIDA). This funding will help Sonara further its mission to support OTP patients with a remote dosing solution that simplifies adherence to methadone treatment programs. This is the company's second NIDA grant of the 2024 fiscal year. Recently, Sonara's advocacy efforts also resulted in the state of New Jersey allocating funding in its FY25 budget to support a remote observation pilot program for take-home methadone. These initiatives mark significant achievement, as the company continues to expand its presence in remote methadone treatment. "Securing the NIDA grant and expanding our services in New Jersey brings us one step closer to our mission of supporting Opioid Treatment Program (OTP) patients through advanced technology," said Michael Giles, MD, founder and CEO of Sonara. "We are committed to continuing our efforts to improve patient outcomes and foster trust between patients and their care teams." The $2.5 million Small Business Innovation Research (SBIR) grant awarded by NIDA will fund the second phase of Sonara's Remote Observed Methadone Evaluation (ROME) study. Phase I successfully integrated a measurement-based care (MBC) tool into Sonara's web-based app and demonstrated the feasibility of the approach. Phase II, which launched on October 7, 2024, will utilize a randomized design to: Assess Sonara's impact on treatment retention and opioid use Evaluate the effectiveness of the MBC tool Test the influence of Sonara on patient, program, and payer costs, as well as health-related quality of life Collaborators in this study include Chestnut Health Systems and Family Guidance, Inc. Since launching in 2020, Sonara has expanded from 10 to over 40 locations across 11 states, marking a 30x increase in revenue and dramatically increasing patient access to take-home medication. This growth reflects Sonara's commitment to addressing the opioid crisis through innovative solutions and effective policy initiatives. Most recently, the State of New Jersey allocated funding in its FY25 budget for Sonara to support a remote observation pilot program for take-home methadone. Sponsored by Assemblyman William F. Moen Jr., this initiative aims to increase equitable access to take-home methadone, demonstrating its clinical and cost-effectiveness and improving patient satisfaction. "The inclusion of this pilot program in New Jersey's budget underscores our commitment to adopting innovative solutions that provide equitable access to treatment for all residents affected by the opioid epidemic," said Assemblyman William F. Moen Jr. Sonara will administer this program in partnership with the NJ Association for the Treatment of Opioid Dependence and various OTPs across the state. "Outpatient clinics usually dispense methadone over a few hours time span. Allowing residents to have increased access to their medicine with remote therapeutic monitoring allows them to have more time to focus on their recovery," said Senator Nilsa Cruz-Perez, who co-sponsored the budget resolution. Sonara is dedicated to reducing barriers to treatment and enhancing the virtual dosing workflow. Future plans include integrating remote intakes, tele-counseling, and generative AI to support comprehensive virtual care for patients with opioid use disorder. About Sonara Health: Sonara Health® is dedicated to supporting OTP patients with a remote dosing solution that simplifies adherence to methadone treatment programs. The patented Virtual Dosing Window™ allows patients to record their take-home doses via a phone or computer, providing care teams with real-time insights to make informed treatment decisions. By increasing the likelihood of earning more take-home doses, Sonara improves program retention rates and enhances the quality of care. For more information about Sonara and its innovative solutions, visit sonarahealth.com. About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit . SOURCE Sonara Health WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

Phase 2Phase 1

100 Deals associated with Methadone Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D02102	Methadone Hydrochloride	N07BC02	DB00333

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Indication	Country/Location	Organization	Date
Cancer Pain	JP	Shionogi & Co., Ltd.	01 Mar 2013
Opioid-Related Disorders	CN	Central Pharmaceutical JSC No. 3	01 Jan 1997
Opioid abuse	US	Hikma Pharmaceuticals USA, Inc.	14 Mar 1973
psychological symptoms behavior compulsive behavior addiction	US	Hikma Pharmaceuticals USA, Inc.	14 Mar 1973
psychological symptoms behavior compulsive behavior addiction	US	SpecGx LLC	14 Mar 1973
Opium Dependence	US	Mylan Institutional LLC	13 Aug 1947
Pain	US	Mylan Institutional LLC	13 Aug 1947

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Indication	Highest Phase	Country/Location	Organization	Date
Diabetic Neuropathies	Phase 2	-	Methapharm, Inc.	01 Jan 2012

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05244226 (CTgov)	Phase 2	Sleep Apnea, Obstructive \| Tonsillitis \| Pain, Procedural	66	Hydromorphone+Fentanyl	tlwnrtcqxc(idzsxkktth) = rzaocquibo qaclmezfew (tulbriylgz, vnmqmqokhd - xvfjpurvbi) View more	-	17 Oct 2024
Pubmed \| Anesthesiology	Not Applicable	-	60	Methadone 0.1 mg/kg	fshgsxaqgc(cqjantyhxj) = tvnmxgtfmd hdbuyyespr (kqwfjezwea, 0.1 - 1.4)	Positive	01 Sep 2024
				Methadone 0.15 mg/kg	fshgsxaqgc(cqjantyhxj) = pihrjkfrsr hdbuyyespr (kqwfjezwea, 0 - 1.4)
NCT03033732 (Pubmed \| HIV Med)	Phase 4	Opioid abuse	272	Methadone	hxsaqptelz(rkzccgwbwh) = bpdqzgzbza teuaxrdgzw (tvltlqjxho ) View more	Positive	01 Jul 2024
				Buprenorphine/naloxone	hxsaqptelz(rkzccgwbwh) = jgxbqlfgrp teuaxrdgzw (tvltlqjxho ) View more
NCT03033732 (Pubmed \| Can J Psychiatry) Manual	Phase 4	Opioid abuse	268	methadone or buprenorphine/naloxone	-	Negative	01 Mar 2024
				Methadone Maintenance Therapy (MMT)	wxswnwdcku(jdczphqgrb) = lbnjyugfvz ghtdobhjxd (wolmfhanbi ) View more
NCT02252432 (CTgov)	Phase 4	Pain, Postoperative	13	methadone+Ketamine (Ketamine)	xhsvazyzan(zixxarrxqp) = mqwuzdfiqc nointszzua (dszgxpxtjl, ilzfoyadfu - acmrkynqri) View more	-	29 Feb 2024
				methadone+ketamine (Methadone)	xhsvazyzan(zixxarrxqp) = wehoqzpbiz nointszzua (dszgxpxtjl, ciutsqutqv - yycwrpugla) View more
WSC2023	Not Applicable	-	-	Opioid medications	ckescqkivr(paobddntpv) = wibivaeefi rxhkscyaio (csmdgbfmof )	-	23 Oct 2023
EUCTR2018-004351-20-DK \| NCT03908060 (Pubmed)	Phase 4	-	-	Methadone 0.2 mg/kg	hrnyvmobkc(ibfiqhindc) = qnecsrdcgu kxbzbjdvqr (yldgeudlkh )	-	01 Sep 2023
				Morphine 0.2 mg/kg	hrnyvmobkc(ibfiqhindc) = tccimysrsz kxbzbjdvqr (yldgeudlkh )
NCT02851303 (CTgov)	Phase 4	Neonatal Abstinence Syndrome	61	Morphine (Morphine)	xwyafcsjdv(btytfvacdi) = azvautzrfn auggqzgbki (frsgbcelij, bpsqzdtwty - qdmrwownoa) View more	-	24 May 2023
				Methadone (Methadone)	xwyafcsjdv(btytfvacdi) = rehwyiqwtz auggqzgbki (frsgbcelij, xdxzebbwar - zkhdgpoyxk) View more
NCT02558010 (CTgov)	Phase 3	Pain \| Scoliosis	58	Methadone+Morphine (Methadone Group)	icxbwkacfw(zcdixqgclm) = klhbuihkgv nybsglchlk (yvcwiijblx, ontzpppjrb - ckuykhijli) View more	-	27 Apr 2023
				Morphine+Normal Saline (Control Group)	icxbwkacfw(zcdixqgclm) = vxtrhcmtia nybsglchlk (yvcwiijblx, jwmagqnbdf - wagiyiqkyy) View more
NCT02989597 (MAPS, CTgov)	Phase 4	Pain, Postoperative	10	Spinal Fusion Surgery+Sufentanil+Methadone Hydrochloride+Dexamethasone+ketamine+Remifentanil (Intra-operative Methadone Hydrochloride)	nhorrjutep(yovrwxbdxg) = uvkopwuizx ibawlpiagr (zzkipxmdgp, pllqelgyhd - brfqaolaqy) View more	-	25 Apr 2023
				Spinal Fusion Surgery+Sufentanil+Dexamethasone+ketamine+Remifentanil (Control)	nhorrjutep(yovrwxbdxg) = xchixjopko ibawlpiagr (zzkipxmdgp, sujljtlpae - rilrulxbdn) View more

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