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减肥手术后阿片类药物的处方和消费:一个多中心前性队列研究
Shrieda Jain1,2, Maxime Lapointe-Gagner1,2, Naser Alali1,3
1Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.
Surgical endoscopy
|July 17, 2023
概括
减肥手术后,大多数处方的阿片类药丸都没有使用,37%的患者没有服用. 诸如男性性别和较高的BMI等因素预测了消费,这表明个性化疼痛管理是可能的.
科学领域:
- 腹部外科 腹部外科
- 疼痛管理 疼痛管理
- 处方阿片类药物 处方阿片类药物
背景情况:
- 腹部外科手术患者面临着术后阿片类药物过度处方的风险增加.
- 目前的阿片类药物危机需要了解该人口中的阿片类药物消费模式.
研究的目的:
- 量化减肥手术后出院时处方的阿片类药物的消费.
- 在减肥手术患者中识别出出院后阿片类药物消费的预测因素.
主要方法:
- 一个多中心前性队列研究,涉及成年患者进行腹腔镜减肥手术.
- 评估手术前的因素,手术细节,以及释放阿片类药物处方.
- 每周自我报告的阿片类药物消费量,可追踪出院后长达30天.
主要成果:
- 处方的阿片类药物量 (中位数为15片) 明显超过患者的消费量 (中位数为1片).
- 大约78.5%的处方阿片类药丸仍未使用,其中37%的患者不服用阿片类药物.
- 男性性别,较高的BMI,手术前使用阿片类药物,吸烟,抑郁症,解手术和处方药的数量预测了消费量的增加.
结论:
- 大多数在减肥手术后出院时处方的阿片类药物都不会被患者摄入.
- 患者和程序相关因素可以预测阿片类药物消费,从而实现个性化止痛策略.
- 最小的或节省阿片类药物的出院后疼痛管理方法可能是可行的,需要进一步调查.
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