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在减肥手术之前和之后慢性使用阿片类药物
Marsha A Raebel1, Sophia R Newcomer, Liza M Reifler
1Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA. marsha.a.raebel@kp.org
JAMA
|October 3, 2013
概括
大多数在手术前长期使用阿片类药物的减肥手术患者在手术后继续使用阿片类药物,手术后的数量增加. 这凸显了对这些人来说需要改进的疼痛管理策略的需要.
科学领域:
- 腹部外科手术的结果
- 疼痛管理 疼痛管理
- 片类药物使用障碍 片类药物使用障碍
背景情况:
- 肥胖与慢性非癌症疼痛有关.
- 减肥手术对肥胖患者慢性阿片类药物使用的影响尚不清楚.
研究的目的:
- 在减肥手术后评估慢性阿片类药物使用.
- 评估手术前抑郁症,慢性疼痛和手术后的BMI变化对阿片类药物使用的影响.
主要方法:
- 对11,719名腹部外科手术患者 (21岁以上) 的回顾性队列研究.
- 评估了手术前和后1年的阿片类药物使用 (不包括前30天).
- 慢性阿片类药物使用,以发行频率或供应持续时间来定义.
主要成果:
- 8%的患者是手术前的慢性阿片类药物使用者.
- 77%的这些患者在手术后继续使用慢性阿片类药物.
- 平均每日阿片类药物使用在术后增加 (45.0毫克至51.9毫克).
- 体重指数下降,手术前抑郁或慢性疼痛并没有显著改变阿片类药物使用的变化.
结论:
- 经过减肥手术的绝大多数慢性阿片类药物使用者在术后继续使用.
- 在减肥手术后,阿片类药物的消费往往会增加.
- 增强的疼痛管理协议对于这种患者群体至关重要.
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