关节镜手术中的阿片类药物节约策略:随机对照试验的系统审查和元分析
Seper Ekhtiari1,2, Nicholas Nucci3, Fares Uddin4
1Division of Trauma and Orthopaedics, Addenbrooke's Hospital-Cambridge University Hospitals, Cambridge, United Kingdom.
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|July 17, 2023
概括
非阿片类药物口服止痛药有效地减少了关节镜手术后的阿片类药物消耗,一些证据支持TENS,冷疗法和用于疼痛管理的睡眠辅助剂. 这些非侵入性策略可以尽量减少骨科手术中阿片类药物的使用.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度处方阿片类药物是整形外科的一个重要问题.
- 关节镜外科手术提供了一个机会,通过有效的疼痛管理辅助来减少阿片类药物的使用.
- 这项研究研究了术后骨关节镜手术恢复的非侵入性疼痛管理方法.
研究的目的:
- 确定非侵入性疼痛管理策略,有效地管理关节镜手术后的疼痛.
- 为了确定哪些模式可以在关节镜后减少阿片类药物摄入量.
- 为临床实践提供基于证据的建议.
主要方法:
- 在PubMed,MEDLINE,EMBASE,Scopus和Web of Science数据库中进行系统搜索.
- 包括随机对照试验 (RCT) 评估关节镜患者的非侵入性疼痛管理.
- 从符合条件的研究中对疼痛评分和阿片类药物消费数据的元分析.
主要成果:
- 分析了21个涉及2,148名患者的RCT.
- 非阿片类药物口服止痛疗法在术后24小时内显著降低了阿片类药物的消耗.
- 通过皮肤进行电神经刺激 (TENS),冷治疗和皮显示出治疗疼痛和减少阿片类药物的潜力.
结论:
- 多种模式的非阿片类口服止痛药,可能包括患者教育,有强有力的证据支持治疗疼痛和减少阿片类药物的使用.
- 通过皮肤进行电神经刺激 (TENS),冷治疗和非二胺类睡眠辅助药物显示出有前途.
- 需要临床指导方针来将这些附加剂纳入常规实践,以减少阿片类药物处方和消费.
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