在分阶段的双边全关节关节整形术中,阿片类药物消费和动员:我们第一次学习了我们的教训吗?
Thomas Bieganowski1, David N Kugelman1, James E Feng1
1Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York.
The Journal of arthroplasty
|June 18, 2023
概括
阶段双边全关节或膝关节置换的结果与第一和第二次手术的结果相似. 手术后有限的阿片类药物使用不会对疼痛或功能产生负面影响,支持阿片类药物节省协议.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 双边关节炎往往需要进行分阶段的关节整形手术 (THA) 或全膝关节整形手术 (TKA).
- 在第一阶段和第二阶段手术之间评估术后结果对于患者管理至关重要.
研究的目的:
- 为了比较第一阶段和第二阶段全关节整形术 (TJA) 之间的术后结果.
- 评估阿片类药物节约方案对阶段性TJAs的结果的影响.
主要方法:
- 在2017年至2021年期间,对961名患者进行了分阶段双边THA或TKA (1922项手术) 的回顾性审查.
- 机构阿片类药物节约协议实施前后结果的比较.
- 分析住院,出院,阿片类药物使用 (MME),疼痛得分和AM-PAC得分.
主要成果:
- 第一个和第二个TJA之间在住院,出院处置,阿片类药物使用,疼痛或AM-PAC得分方面没有显著差异.
- 结果与阿片类药物缓解方案相比,无论时间如何,都保持一致.
结论:
- 分阶双边THA和TKA在两种手术中产生类似的术后结果.
- 在不影响疼痛控制或功能恢复的情况下,可以安全地实施阿片类药物节约方案.
- 这些发现支持减轻骨科手术中阿片类药物流行病的策略.
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