片类药物对在手术室内主观幸福感的止痛作用
M Eikemo1,2, I M Meier2, G E Løseth1,1
1Department of Psychology, University of Oslo, Oslo, Norway.
Anaesthesia
|June 29, 2023
概括
阿片类止痛药,如雷米芬坦尼尔和氧化,很少改善手术患者的幸福感. 以前的阿片类药物暴露增加了积极的健康影响的可能性,可能导致持续使用.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 手术后的阿片类药物暴露是新的持续阿片类药物使用的风险因素.
- 假设阿片类药物滥用责任源于改善的幸福感和缓解焦虑.
- 以前的研究表明,阿片类药物不会在健康个体中持续改善情绪.
研究的目的:
- 在临床环境中调查雷米芬坦尼尔和氧化对患者主观幸福感和焦虑的作用.
- 为了确定未使用过阿片类药物的患者是否经历了急性阿片类药物管理后改善的幸福感.
- 探索先前阿片类药物暴露和主观阿片类药物影响之间的关系.
主要方法:
- 涉及白天手术患者的观察性研究.
- 患者在开放式注射雷米芬坦尼尔或氧化注射前和之后自我评估了健康和焦虑.
- 分析包括科恩的d,贝叶斯因子和后勤回归.
主要成果:
- 患者在阿片类药物给药后报告中毒.
- 阿片类药物产生了适度的焦虑减轻 (科恩的d = 0.21-0.31).
- 反对同时改善幸福感的证据中等至强 (贝叶斯因子>6).
- 雷米芬坦尼尔降低了"感觉良好"评级;氧化在三分之一的患者中改善了幸福感.
- 在先前暴露于阿片类药物 (OR = 4.4 超过2周使用) 的患者中,改善幸福感的可能性更高.
结论:
- 在未曾服用过阿片类药物的手术患者中,阿片类药物诱导的幸福感改善是罕见的.
- 在外科手术期间接触阿片类药物可能会增加持续使用的风险,通过增强随后的积极主观效应.
- 临床实践显示,与健康志愿者的实验室研究相比,主观效应不同.
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