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国家立法和机构协议对小儿桃体切除术后阿片类药物处方实践的影响
Lisa M Einhorn1, Congwen Zhao2, Benjamin A Goldstein2,3
1Division of Pediatric Anesthesiology, Department of Anesthesiology Duke University Medical Center Durham North Carolina USA.
Laryngoscope investigative otolaryngology
|June 21, 2023
概括
在国家立法和制度变化之后,小儿桃体切除术的阿片类药物处方显著下降,减少了40%的氧化剂量. 然而,尽管采取了干预措施,处方实践的变化仍然存在.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 疼痛管理 疼痛管理
- 公共卫生政策 公共卫生政策
背景情况:
- 桃体切除术是一种常见的儿科手术,疼痛管理是恢复的关键方面.
- 阿片类药物流行病导致儿童手术后使用阿片类药物的限制.
- 很少有研究评估了这些阿片类药物限制对儿科耳鼻喉科实践的影响.
研究的目的:
- 分析北卡罗来纳州阿片类药物立法和机构协议实施后阿片类药物处方模式的变化.
- 量化了小儿桃体切除术患者处方的氧化剂量减少.
主要方法:
- 一个单一中心的回顾性队列研究分析了2014年至2021年1552名儿科桃体切除术患者记录.
- 处方做法被评估在三个时期:立法前,立法后/协议前和协议后.
- 测量的主要结果是每处方的氧化剂量数量.
主要成果:
- 平均每处方的氧化剂量从58±53 (第1期) 降至28±36 (第2期) 和23±17 (第3期).
- 与1期相比,2期和3期的干预与41%和40%的剂量减少有关.
- 在2018年北卡罗来纳州立法后,观察到每年剂量下降9%,但仍然存在显著的变化.
结论:
- 立法和制度干预显著减少了儿童桃体切除术的氧化处方.
- 在干预后观察到,每处方的氧化剂量减少了40%.
- 尽管减少了,但阿片类药物处方方案的变化仍然存在,这表明需要进一步优化.
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