在接受TKA的患者进行手术前的药基因组测试可以改善术后疼痛吗? 一个随机试验
Molly B Kraus1, Joshua S Bingham2, Adrijana Kekic3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA.
Clinical orthopaedics and related research
|August 18, 2023
概括
在接受全膝关节整形手术 (TKA) 的患者中,手术前的药物基因组测试没有改善疼痛控制或减少阿片类药物的使用. 对于特定的患者群体需要进一步的研究.
科学领域:
- 药物基因组学 药物基因组学
- 疼痛管理 疼痛管理
- 整形外科手术 整形外科手术
背景情况:
- 药物基因组学为手术后个性化疼痛管理提供了潜力.
- 止痛疗效和不良事件的个体间变化是一个挑战.
- 对于全膝关节整形术 (TKA) 患者进行手术前的药物基因组测试的实用性仍然不清楚.
研究的目的:
- 为了确定手术前的药物遗传测试是否与较低的术后疼痛评分 (OBAS) 有关.
- 评估药物基因组测试是否减少了阿片类药物总给药量.
- 为了评估药物基因组测试后阿片类药物处方模式的变化.
主要方法:
- 一个随机试验,涉及18-80岁的年轻人接受初级TKA.
- 患者接受了手术前的药物基因组测试,药剂师审查或标准护理.
- 主要结局是止痛药评分的整体益处 (OBAS);次要结局包括疼痛评分和阿片类药物消费.
主要成果:
- 药基因组测试组和对照组之间的平均OBAS没有显著差异 (p=0.55).
- 总的阿片类药物消费量和处方模式在各组之间没有显著差异.
- 在对多次比较进行调整后,特拉马多尔使用没有显著差异.
结论:
- 在TKA患者中,常规的手术前药物基因组测试没有增强疼痛控制或减少阿片类药物使用.
- 未来的研究应该调查高风险人群或复杂程序中的药物基因组学.
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