减肥手术后的阿片类止痛药:评估阿片类药物相关危害的生理风险因素的范围审查
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Stephanie C M Wuyts1,2, Bart Torensma3, Arnt F A Schellekens4
1Pharmacy Department, Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium.
Journal of clinical medicine
|July 14, 2023
概括
腹部外科手术患者因遗传学,疼痛和药物吸收改变而面临较高的阿片类药物相关伤害风险. 了解这些因素对于预防阿片类药物使用障碍 (OUD) 手术后至关重要.
科学领域:
- 腹部外科 腹部外科
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
背景情况:
- 减肥手术后的阿片类药物使用是一个重大问题,增加了与阿片类药物相关的伤害 (ORM) 和阿片类药物使用障碍 (OUD) 的风险.
- 接受减肥手术的患者往往已经存在对物质使用障碍的脆弱性.
研究的目的:
- 审查影响腹部外科手术后术后阿片类药物相关损害 (ORM) 的生理因素.
- 在减肥患者群体中确定ORM,特别是OUD的关键风险变量.
主要方法:
- 从1990年到2023年,PubMed的综合文献审查.
- 专注于确定对术后ORM的生理影响.
主要成果:
- 由于遗传倾向,神经生物学变化和成倾向,患者的风险更高.
- 慢性疼痛,手术类型,以及在肥胖中改变疼痛感知会影响阿片类药物需求和长期使用.
- 胃肠道的变化会影响微生物组和阿片类药物吸收,导致系统性暴露变化.
结论:
- 腹腔外科手术后的ORM风险被先前存在的成倾向,手术疼痛,改变的肠-大脑相互作用和药理学所放大.
- 需要进一步的研究来澄清这个人群中ORM和OUD的特定风险变量.
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