在术后期照顾我们的阿片类药物使用障碍患者:麻醉科医生指南
Antje M Barreveld1, Andrew Mendelson2, Brittany Deiling2
1From the Department of Anesthesiology, Tufts University School of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts.
Anesthesia and analgesia
|August 17, 2023
概括
麻醉师可以在手术期间改善对阿片类药物使用障碍 (OUD) 患者的护理. 本指南提供了管理OUD,促进康复和改善患者结果的策略.
科学领域:
- 麻醉学 麻醉学
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类药物使用障碍 (OUD) 是一个重大的全球健康挑战.
- 麻醉科医生对于管理OUD患者的术后发病率和死亡率至关重要.
- 这篇文章是关于在麻醉中管理物质使用障碍的系列文章的一部分.
研究的目的:
- 为麻醉科医生提供有关管理OUD患者的教育资源.
- 概述OUD (MOUD) 药物治疗患者和那些活跃的,未经治疗的OUD患者的术后考虑.
- 详细介绍多式外围手术护理的非阿片类药物疼痛管理策略.
主要方法:
- 审查当前的证据和最佳实践对OUD管理在外科外科设置.
- 结构化的教育内容分为四个关键部分.
- 为麻醉科医生制定一个逐步的方法来支持OUD治疗.
主要成果:
- OUD管理需要知情的术后团队和基于证据的护理.
- 对于MOUD患者和那些有活跃的,未经治疗的OUD患者,存在特殊考虑.
- 非药物和非阿片类药物策略对于疼痛管理至关重要.
结论:
- 麻醉科医生可以通过领导OUD的术后护理显著影响患者的结果.
- 实施建议的最佳实践可以帮助挽救生命并促进康复.
- 一种结构化,逐步的方法有助于在整个手术过程中支持OUD患者.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
335
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
335
Opioid Analgesics: Morphine and Other Natural Cogeners
291
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
291
Analgesia and Pain Management
654
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
654
Stages of General Anesthesia
497
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
497
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
115
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
115
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8


