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在患有慢性疼痛的老年患者中,阿片类药物和 gabapentinoids 之间的疼痛控制的比较有效性
Emily Kim1, Mukaila A Raji2,3,4, Jordan Westra5
1School of Medicine, University of Texas Medical Branch, Galveston, TX, United States.
Pain
|August 10, 2023
概括
与阿片类药物相比, gabapentinoid 药物在减少限制活动的慢性疼痛方面表现出更大的有效性. 较高的 gabapentinoid 剂量与更好的疼痛减轻结果有关.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 根据2016年阿片类药物指南, gabapentinoid的处方量显著增加.
- 转向 gabapentinoids 假定与阿片类药物同等的止痛效果,缺乏比较数据.
研究的目的:
- 为了比较 gabapentinoids 与阿片类药物治疗慢性疼痛的止痛效果.
- 为了评估随着时间的推移在 gabapentinoid 和阿片类药物使用者之间限制活动疼痛的变化.
主要方法:
- 对2017-2019年慢性疼痛患者的医疗保险数据进行了回顾性分析,这些患者开始服用 gabapentinoid 或阿片类药物处方.
- 在60天的窗口内,从处方前到处方后的评估中评估了与活动有关的疼痛干扰的减少.
- 根据患者的人口统计和并发性疾病进行调整.
主要成果:
- gabapentinoid 用户的疼痛干扰减少了 48.1%,而阿片类药物用户的疼痛干扰减少了 41.7%.
- 加巴类药物的使用与处方后实现每日疼痛低于每日疼痛的几率显著增加 (OR = 1.29).
- 观察到一种剂量依赖的关系,更高的加巴丁胺剂量产生更大的疼痛缓解.
结论:
- 与阿片类药物相比, gabapentinoids 在减少限制活动的慢性疼痛方面表现出更大的有效性.
- 使用 gabapentinoid,特别是高剂量,与改善疼痛结果有关.
- 对处方 gabapentinoids 或阿片类药物的患者的功能结果进行进一步的研究是有必要的.
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