术后用德克萨米他不会减少术后使用阿片类药物,在前宫椎切除和融合之后
Yunsoo Lee1, Tariq Ziad Issa1, Teeto Ezeonu1
1Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
World neurosurgery
|June 21, 2023
概括
在接受前椎切除和融合的患者中,外科术期间的德克萨米他并没有减少住院或术后的阿片类药物消耗. 止痛不应该是使用德克萨米他在这个患者群体的主要原因.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在前椎间盘切除和融合 (ACDF) 后使用阿片类药物很常见.
- 德克萨米他有时用于外科手术,但其对ACDF患者阿片类药物消费的影响尚不清楚.
研究的目的:
- 调查外科手术期间的德克萨米他给药是否减少了阿片类药物在住院期间和术后在ACDF患者的消耗.
- 为了评估甲剂量对阿片类药物使用的影响.
主要方法:
- 对接受初级选择性1至4级ACDF的成年患者进行回顾性研究.
- 从处方药监测计划和药物记录中使用吗啡毫克相当量 (MMEs) 来量化阿片类药物的使用.
- 根据德克萨米他的使用 (是/否) 和剂量 (高/低) 分类的患者.
- 多变量线性回归用于分析德克萨米他和MMEs之间的关联,控制混因子.
主要成果:
- 在249名患者中,167人接受了德克萨米他.
- 两组之间每日住院阿片类药物的使用没有显著差异 (39.4MMEs/天与德克萨米他松相比56.7MMEs/天没有).
- 在任何时间点 (0-12周,3个月至1年) 的术后阿片类药物处方补充中没有显著差异.
- 多变量分析显示,德克萨梅他和降低的阿片类药物量之间没有关联.
结论:
- 在外科手术期间给予德克萨米他并没有显著减少ACDF患者的住院或家庭阿片类药物使用.
- 德克萨米他的基于体重的剂量没有影响其对阿片类药物消费的影响.
- 在ACDF程序中,甲不应主要用于止痛.
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