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Optimización de la prescripción de opioides postoperatorios en veteranos sometidos a artroplastias totales de cadera
Taylor Lueder1, Brittany Faley1, Tamara Dixon1
1Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA.
Journal of pain & palliative care pharmacotherapy
|January 28, 2026
Resumen
La prescripción de opioides después de la cirugía de reemplazo de cadera o rodilla muestra inconsistencias. Muchos pacientes recibieron opioides a pesar de no necesitarlos, lo que indica la necesidad de protocolos estandarizados de manejo del dolor.
Área de la Ciencia:
- Cirugía Ortopédica
- Manejo del Dolor
- Farmacología
Sus antecedentes:
- La prescripción de opioides después de la cirugía ortopédica presenta riesgos como dependencia y sobreprescripción.
- La optimización del manejo del dolor después de la artroplastia total de cadera (ATC) y la artroplastia total de rodilla (ATR) es crucial.
Objetivo del estudio:
- Evaluar los patrones de prescripción de opioides postoperatorios en veteranos que no han usado opioides y se someten a ATC o ATR.
- Identificar variaciones en el uso y la documentación de opioides para la mejora de la calidad.
Principales métodos:
- Análisis retrospectivo de 142 veteranos que no han usado opioides en un centro médico de VA único.
- Examen de los datos de prescripción de opioides para pacientes de ATC y ATR entre septiembre de 2023 y septiembre de 2024.
Principales resultados:
- Los pacientes de artroplastia total de rodilla (ATR) recibieron dosis diarias equivalentes de morfina (MEDD) más altas que los pacientes de artroplastia total de cadera (ATC).
- El 11% de los pacientes fueron dados de alta con opioides a pesar de no haber usado opioides recientemente en el hospital.
- Se observaron prácticas inconsistentes de prescripción y documentación.
Conclusiones:
- Los hallazgos resaltan oportunidades significativas para mejorar la prescripción y documentación de opioides postoperatorios.
- Las recomendaciones incluyen analgesia multimodal estandarizada, promoción de analgésicos no opioides y coinscripción de naloxona.
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