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オピオイド薬の慢性的な使用は,減量外科手術の前と後の
Marsha A Raebel1, Sophia R Newcomer, Liza M Reifler
1Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. marsha.a.raebel@kp.org
JAMA
|October 3, 2013
まとめ
外科手術前に慢性的にオピオイドを使用していた大部分の減量外科手術患者は,手術後の使用を継続し,手術後の使用量は増加しました. これは,これらの個人に向けて改善された痛みの管理戦略の必要性を強調しています.
科学分野:
- 減量手術の結果について
- 疼痛管理 疼痛管理
- オピオイド使用障害 オピオイド使用障害
背景:
- 肥満は慢性非がん性疼痛と関連しています.
- 肥満患者の慢性オピオイド使用に対する減量外科手術の影響は十分に理解されていません.
研究 の 目的:
- 減量手術後の慢性的なオピオイド使用を評価するために.
- オピオイド使用に対する術前うつ病,慢性疼痛,術後のBMI変化の影響を評価する.
主な方法:
- 11,719人の重症外科手術患者 (21歳以上) の遡及的なコホート研究.
- オピオイドの使用は,手術前の1年および手術後の1年 (最初の30日間を除く) を評価した.
- 慢性的なオピオイド使用は,投与頻度または供給期間によって定義されます.
主要な成果:
- 患者の8%は,手術前の慢性的なオピオイド使用者でした.
- これらの患者の77%が,手術後の慢性的なオピオイド使用を継続した.
- 平均的なオピオイドの使用量は,手術後 (45.0 mgから51.9 mg) に増加しました.
- BMIの低下,手術前うつ,慢性疼痛は,オピオイド使用の変化を有意に変化させなかった.
結論:
- 減量手術を受けた慢性オピオイド使用者の大部分は,手術後の使用を継続しています.
- オピオイドの消費は,減量手術後に増加する傾向があります.
- 強化された疼痛管理プロトコルは,この患者集団にとって極めて重要です.
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