オピオイドの使用は,近接骨骨折と病理骨折の比較です
Austin Yu1, Conor M Jones2, Gayathri Vijayakumar3
1Rush University Medical Center, Chicago, Illinois. ORCID: https://orcid.org/0000-0003-0076-277X.
Journal of opioid management
|September 4, 2025
まとめ
この研究では,病理的な骨折の患者は手術前により多くのオピオイドを必要としながら,近接骨折の内部固定から3ヶ月と6ヶ月後に機能的な改善が見られた. 手術後のオピオイド使用は有意に変化しなかった.
科学分野:
- 整形 術
- 腫瘍学
- 痛みの管理
背景:
- 近い股関節の病理的および差し迫った骨折は,しばしば外科的介入を必要とします.
- 患者は以前からオピオイドを使用しており,手術後の痛み管理が必要です.
- 内部の固定はこれらの骨折の一般的な治療法です.
研究 の 目的:
- 外科手術後のオピオイド使用と,近親股骨骨折の内定後3ヶ月と6ヶ月後の機能的アウトカムを比較する.
- 病理的な骨折と 迫り来る骨折を区別する
- 手術後のオピオイド使用に関連する危険因子を特定する.
主な方法:
- 近い股関節骨折に対する内部固定手術を受けた患者に関する遡及的症例対照研究 (2016年-2022年).
- 術前と術後のオピオイド摂取量 (モルヒンのミリグラム相当) の分析
- 外科手術後3ヶ月と6ヶ月で外科機能状態の評価
主要な成果:
- 病理的な骨折は24件, 近い骨折は23件.
- 手術前におけるオピオイド使用量が 顕著に増加した.
- 手術後3か6ヶ月で,オピオイド使用の有意な差異は観察されなかった.
- 3ヶ月と6ヶ月で歩行状態の有意な改善は,全体的な骨折と迫り来る骨折のコホートで観察されました.
結論:
- 骨折の種類に関係なく,内部の固定が近辺骨折の患者の機能改善につながります.
- 病理的な骨折は 手術前より高いオピオイド用量が必要です
- 疼痛管理戦略と腫瘍の特徴が手術後のオピオイド需要に与える影響を調べるためにさらなる研究が必要である.
関連する概念動画
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
419
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...
419
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
360
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
360
01:25Analgesia and Pain Management
788
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
788
01:22Opioid Receptors: Overview
1.8K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
1.8K
01:27Fractures: Bone Repair
3.6K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
3.6K