在老年人中,在全身麻醉下选择性手术后的慢性疼痛
Mingyang Sun1, Wan-Ming Chen2,3, Szu-Yuan Wu4,5,6,7,8,9,10,11,12
1Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Journal of anesthesia
|June 24, 2023
概括
老年人经历较高的长期止痛药使用率慢性术后疼痛 (CPSP) 选择性手术后. 这凸显了需要考虑与年龄相关的因素来管理老年患者手术后疼痛的需要.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 疼痛管理 疼痛管理
背景情况:
- 慢性术后疼痛 (CPSP) 是选择性手术后的一个重大问题.
- 对于CPSP的年龄和长期止痛药的使用之间存在关联的研究有限.
- 老年人可能对术后疼痛和镇痛有不同的反应.
研究的目的:
- 调查患者年龄与慢性术后疼痛 (CPSP) 之间的关联.
- 为了比较老年人 (≥65岁) 和年轻患者 (<65岁) 之间的长期术后止痛药的使用情况.
- 在长期的术后止痛需求的背景下,研究年龄的作用.
主要方法:
- 采用了一种倾向分数匹配 (PSM) 研究设计.
- 年龄组之间的长期 (3或6个月) 术后止痛药使用的比较.
- 多变量逻辑回归分析了止痛药的使用作为CPSP的替代品.
主要成果:
- 这项研究包括62,784名患者,每年龄组31,392名患者.
- 老年人显示,在手术后3个月 (aOR,1.45) 和6个月 (aOR,1.52) 的止痛药使用率显著更高.
- 在这两个时间点中,在老年人中也观察到更高的特定阿片类药物使用率.
结论:
- 老年人在全身麻醉后对CPSP长期使用止痛药的比例增加.
- 年龄是影响术后疼痛管理的关键因素.
- 需要进一步的研究和量身定制的策略来管理老年人群中的CPSP.
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