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心臓インプラント可能な電子機器の手続き後の持続的なオピオイド使用

Timothy M Markman1, Chase R Brown2, Lin Yang3

  • 1Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

Circulation
|November 15, 2021
PubMed
まとめ

持続的なオピオイド使用 (POU) は,心臓埋め込み電子装置 (CIED) 処置後に一般的であり,患者の12%に影響します. オピオイドの初期投与量が高いと,POUの発生リスクが高くなります.

キーワード:
鎮痛剤 オピオイドインプラント式除細動器ペースメーカー

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科学分野:

  • 心臓病科
  • 痛みの管理
  • 公衆衛生

背景:

  • 処方されたオピオイドは,持続的なオピオイド使用 (POU) の流行に大きく貢献しています.
  • 心臓埋め込み電子機器 (CIED) による手術後のPOUの発生率は不明です.

研究 の 目的:

  • CIEDの処置後のオピオイド未使用患者のPOUの発生率を決定する.
  • この患者集団におけるPOUに関連する危険因子を特定する.

主な方法:

  • 国内行政請求データベース (2004年−2018年) を用いた遡及コホート研究
  • 180日以内に他の処置を受けた患者を除く CIED処置を受けた未使用の成人の患者を含む.
  • オピオイドの処方箋で定義されたPOUは,CIEDの手術後の30日以上です.

主要な成果:

  • 143,400人の適格患者の11%がCIED手術の14日以内にオピオイドを受けた.
  • POUは,これらの患者の12. 4% (手術後30~180日) に発生した.
  • POUの危険因子には,以前の薬物乱用,筋肉リラックス剤/ベンゾジアゼピン使用,およびより高い初期経口モルヒン相当量 (> 135 mg) が含まれていた.

結論:

  • POUはCIEDの手続き後の一般的な結果であり,患者の12%が30日を超えてオピオイドの使用を継続しています.
  • オピオイド処方薬の初期投与量が高いと,POUの発症のリスクが高まります.