麻醉辅助与布普伦诺芬或克罗尼丁辅助的海洛因解毒和纳尔特雷克松诱导:一个随机试验
Eric D Collins1, Herbert D Kleber, Robert A Whittington
1Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. edc3@columbia.edu
JAMA
|August 25, 2005
概括
这项研究不支持用于阿片类药物解毒的全身麻醉. 与克洛尼丁相比,麻醉辅助和布普伦诺芬辅助方法显示了较高的纳尔特雷克松诱导率,但没有改善保留率.
科学领域:
- 成 药物 药物 药物 药物
- 药理学 药理学是指药理学的学科.
- 麻醉学 麻醉学
背景情况:
- 麻醉辅助的快速阿片类药物解毒是一种昂贵的,未经证实的阿片类药物依赖治疗方法.
- 这种方法涉及在全身麻醉下诱导阿片类抗体.
研究的目的:
- 将麻醉辅助解毒与快速对抗剂诱导与两种海洛因依赖的替代方法进行比较.
- 这项研究旨在评估不同排毒策略的有效性和安全性.
主要方法:
- 106名海洛因依赖患者被随机分为三个组:麻醉辅助,布普伦诺芬辅助或克洛尼丁辅助解毒.
- 所有组都接受了72小时的住院治疗,随后进行了12周的门诊纳尔特雷克松维护和心理治疗.
- 结果包括戒断严重程度,纳尔特雷克松诱导率,治疗完成,保留和阿片类药物阳性尿液测试.
主要成果:
- 在所有组中,戒断的严重程度都相似.
- 与克隆尼丁 (21%),相比,麻醉和布普伦诺芬辅助方法的纳尔特雷克松诱导率 (94%和97%) 显着更高.
- 在住院患者的解毒完成或12周的治疗持续时间方面没有发现显著差异. 麻醉与不良事件有关.
结论:
- 一般麻醉不推用于海洛因排毒和快速阿片类药物抗剂诱导.
- 虽然麻醉辅助和布普伦诺芬辅助方法可以改善纳尔特雷克森的诱导作用,但它们不能提高长期治疗的持续性.
- 纳尔特雷克松诱导显著降低了中断的风险.
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