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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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外科医の膝関節整形手術におけるオピオイド処方パターンの性別による差異

Jiwoo Park1, Graham Sabo1, Mayuri Jain2

  • 1Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

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まとめ
この要約は機械生成です。

外科医の膝関節整形手術 (TKA) の後,オピオイドの投与量が高かったが,手術後のオピオイド使用の可能性は低かった. 女性はTKAの後に持続的なオピオイド使用のリスクが高くなります.

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科学分野:

  • 整形外科
  • 痛みの管理
  • 薬理学について

背景:

  • 膝関節整形手術 (TKA) の後のオピオイドの処方における性別による差異は知られていますが,診療室と高齢者の場合では理解は少ないです.
  • この研究では 外科医のTKAに対する手術後のオピオイド処方における 性差を調査しています

研究 の 目的:

  • 外科医の膝関節整形手術の時期のオピオイド処方パターンの性差を調べる
  • 術後のオピオイドの処方量,処方されたオピオイド用量 (MME),および外科医のTKAを受ける男性と女性の間での亜急性および持続的なオピオイド使用率を比較する.

主な方法:

  • 国内およびメディケアサプリメントデータベース (2018-2021) を用いた遡及コホート研究.
  • 18歳から64歳までの患者 (商業用) と65歳以上の患者 (メディケア) を含む.
  • 性別とオピオイドとの関連性を分析し,共変数を調整した.

主要な成果:

  • 商業用コホートでは男性よりMMEが多く,亜急性/持続的なオピオイド使用率は女性より低い.
  • メディケアのコホートでは 男性が処方箋を充填する確率が高く MMEの確率が高く 亜急性オピオイド使用の確率が低かった.
  • 商業用コホートでは,処方箋の充填における性別差は見つかりませんでした.

結論:

  • 外科のTKAを受けた男性は,手術後のオピオイド投与量が高くなったが,手術後のオピオイド継続の可能性は低下した.
  • 外科医のTKAの後,女性は持続的なオピオイド使用のリスクが高く,さらなる調査が必要である.
  • 性別による差異の背後にあるメカニズムを理解することは 痛みの管理とオピオイド管理の最適化に不可欠です