术后甲索卡巴和术后疼痛之间的关联阿片类药物剂量要求:一个回顾性队列研究
Ryu Komatsu1, Michael D Singleton2, Jiang Wu3
1Department of General Anesthesiology and Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH.
The Clinical journal of pain
|June 7, 2023
概括
手术后的美托卡巴摩尔并没有减少肌肉骨手术患者的疼痛或阿片类药物使用. 这种肌肉松剂与疼痛得分增加和阿片类药物需求增加有关,这表明对急性疼痛管理的益处有限.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 整形外科手术 整形外科手术
背景情况:
- 有效的术后疼痛管理对于患者的康复至关重要.
- 类阿片类止痛药是常用的,但存在依赖和副作用的风险.
- 肌肉松剂有时被用作疼痛控制的辅助剂.
研究的目的:
- 评估梅托卡巴摩尔在减少术后疼痛和阿片类药物消耗方面的疗效.
- 测试梅托卡巴摩尔在肌肉骨手术后改善疼痛控制的假设.
主要方法:
- 对9089名接受肌肉骨手术的患者进行了回顾性队列研究.
- 与接受梅托卡巴摩尔的704名患者进行了比较,而8385名患者在术后48小时内没有接受梅托卡巴摩尔.
- 使用倾向性得分加权回归来分析时间加权的平均疼痛得分和阿片类药物剂量要求 (MME).
主要成果:
- 甲索卡巴摩尔的使用与0.97分高的TWA疼痛得分相关 (P <0.001).
- 接受梅托卡巴摩尔治疗的患者在阿片类药物中需要93.6MME以上 (P <0.001).
- 在美托卡巴摩尔组观察到更高的疼痛负担和阿片类药物使用.
结论:
- 手术后的美托卡巴摩尔与增加疼痛和阿片类药物需求有关.
- 这项研究表明,在术后疼痛管理中,美托卡巴摩尔的益处有限或不存在.
- 残留混可能会影响研究结果,但结果表明在使用其时要谨慎.
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