大規模な腹部手術後の非オピオイド鎮痛薬使用の傾向: 一つのセンターコホート研究
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
The Korean journal of pain
|August 21, 2025
まとめ
アセトアミノフェンやNSAIDを含む非オピオイド鎮痛剤の使用は,大きな腹部手術で有意に増加しました. しかし,全体的な利用は,特に手術後の利用は限られており,痛みの管理戦略により広範な統合が必要であることを示しています.
科学分野:
- 麻酔学と痛み管理
- 手術 結果 研究
- 薬用警戒について
背景:
- 非オピオイド鎮痛剤は多様式鎮痛剤とオピオイドを節約するアプローチに不可欠です.
- 非オピオイド鎮痛剤の臨床利用は,その重要性にもかかわらず継続しています.
- この研究は,高級病院の重度の腹部手術患者に焦点を当てています.
研究 の 目的:
- 術後の非オピオイド鎮痛剤投与の傾向を調査する.
- 関連有害事象,特に薬物誘発性肝損傷 (DILI) と急性腎損傷 (AKI) を評価する.
- アセトアミノフェンと非ステロイド抗炎症薬 (NSAIDs) の投与パターンを分析する.
主な方法:
- 2020年1月から2024年12月までの処方箋データの遡及分析
- 術前,術後および術後フェーズ (POD 0 - 3) における鎮痛薬投与の評価
- 傾向分析のための線形回帰と有害事象評価のためのポアソン回帰.
主要な成果:
- アセトアミノフェンの予防投与からPOD2への投与の有意な上昇傾向
- 主にPOD1まで,NSAID投与のわずかな,しかし顕著な増加.
- 両方の鎮痛剤の併用は5%未満で,DILIやAKIと有意な関連性はありませんでした.
結論:
- 5年以上にわたり,大きな腹部手術で非オピオイド鎮痛剤の使用が著しく増加した.
- 整体的な利用は,特に手術後の利用は,限られている.
- 非オピオイドの鎮痛剤を臨床実務に組み込むためのさらなる努力が必要である.
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