在心脏植入式电子设备手术后持续使用阿片类药物
Timothy M Markman1, Chase R Brown2, Lin Yang3
1Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Circulation
|November 15, 2021
概括
在心脏植入式电子设备 (CIED) 程序后,持续使用阿片类药物 (POU) 是常见的,影响12%的患者. 较高的初始阿片类药物剂量增加了POU的风险.
科学领域:
- 心脏病学
- 治疗疼痛
- 公共卫生
背景情况:
- 处方阿片类药物对持续使用阿片类药物 (POU) 的流行有很大影响.
- 在心脏植入式电子设备 (CIED) 程序后,先前未服用阿片类药物的患者中,POU的发生率尚不清楚.
研究的目的:
- 在CIED手术后,确定POU在先前未使用阿片类药物的患者中的发生率.
- 在该患者群体中确定与POU相关的风险因素.
主要方法:
- 使用国家行政索赔数据库 (2004-2018) 进行的回顾性队列研究.
- 包括未服用过阿片类药物的成年患者接受CIED手术,不包括在180天内接受其他手术的患者.
- 定义POU为阿片类药物处方填充>30天后CIED程序.
主要成果:
- 在143,400名符合条件的患者中,有11%的患者在CIED手术后14天内接受了阿片类药物治疗.
- 在这些患者中,POU发生在12. 4% (手术后30-180天).
- 对POU的危险因素包括先前的药物滥用,肌肉松剂/二胺的使用,以及较高的初始口服吗啡相当剂量 (> 135 mg).
结论:
- 在CIED手术后,POU是常见的结果,12%的患者持续使用阿片类药物超过30天.
- 较高的初始阿片类药物处方剂量与发展POU的风险增加有关.
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