在膝关节关节整形术中服用阿片类药物和神经阻塞剂:观察性回顾性评估
Kelsey Welle1, Karen Colorafi1, Kenneth Daratha1
1School of Nursing and Human Physiology, Gonzaga University.
概括
周围神经阻塞 (PNBs) 在全膝关节整形术患者中显著降低了阿片类药物使用和MMEs. PNBs还延迟了第一次阿片类药物的时间,支持它们在阿片类药物减轻疼痛管理中的作用.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 整形外科手术 整形外科手术
背景情况:
- 与阿片类药物相关的不良事件的增加需要非阿片类药物疼痛管理策略.
- 外围神经阻塞 (PNB) 有效控制疼痛,特别是在门诊手术中.
- 膝关节整形术 (TKA) 是一种常见的手术,具有显著的术后疼痛.
研究的目的:
- 评估成年TKA患者的阿片类药物使用模式.
- 为了比较那些接受PNB和那些没有接受PNB的患者之间的阿片类药物消费.
- 确定影响TKA后阿片类药物管理的因素.
主要方法:
- 追溯观察性研究设计.
- 分析了8,493名成年TKA患者的非识别数据集.
- 通过PNB管理对阿片类药物使用频率,MME和第一次阿片类药物的时间进行分层.
主要成果:
- PNB的使用与阿片类药物使用频率的减少有关 (p < .05).
- 接受PNB治疗的患者消耗的MME减少了15毫克 (p < .001).
- PNB增加了第一次阿片类药物给药的时间 (HR 0.70,p < .001).
结论:
- 周围神经阻塞是TKA的有效阿片类药物节约技术.
- 将PNB纳入TKA疼痛管理方案可以降低整体阿片类药物消费.
- PNB支持术后疼痛控制的最佳实践,同时尽量减少阿片类药物依赖.
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