阿片类与非阿片类手术后疼痛管理在耳鼻喉科
Allison Keane1, Kayla Jardine2, David Goldenberg1
1Department of Otolaryngology-Head and Neck Surgery, Penn State Health, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
BMC anesthesiology
|August 25, 2023
概括
与以色列医院相比,美国医院对手术后疼痛处方的阿片类药物明显更多. 这凸显了疼痛管理实践的差异和对阿片类药物流行病的潜在贡献.
科学领域:
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
- 比較醫學是比較醫學.
背景情况:
- 阿片类药物流行病在美国造成了严重的公共卫生危机,造成了严重的死亡率和经济影响.
- 阿片类药物通常用于术后疼痛管理,需要检查处方模式.
- 各国疼痛管理策略的差异可能为缓解阿片类药物危机提供了见解.
研究的目的:
- 为了比较术后的阿片类和非阿片类止痛药疗法.
- 分析在耳鼻喉科手术中治疗疼痛的处方和管理实践.
- 确定在美国和以色列两个三级护理中心之间疼痛管理的差异.
主要方法:
- 对204名接受耳鼻喉科手术的患者 (2017-2019年) 的回顾性图表审查.
- 对手术后止痛药类型和剂量的分析,转换为吗啡毫等效剂 (MME).
- 美国和以色列中心之间的Chi-square和Wilcoxon等级和总和测试的统计比较.
主要成果:
- 与以色列患者相比,美国患者收到的阿片类药物订单 (95%与70%相比) 和管理量显著增加.
- 美国的中位数阿片类药物剂量较高 (45 MME/24h订购,15 MME/24h收到) 与以色列 (30 MME/24h订购,3.8 MME/24h收到).
- 美国的阿片类药物处方在美国 (92%) 比以色列 (4%) 普遍得多,在美国使用的非阿片类药物比如乙氨基和布洛芬,在以色列使用的非阿片类药物比较多.
结论:
- 米尔顿·S·赫希医疗中心 (美国) 与以色列海姆·谢巴医疗中心 (以色列) 相比,对治疗术后疼痛的阿片类药物处方和管理采取了更自由的方法.
- 在这两个中心之间观察到阿片类药物使用和非阿片类药物替代处方的显著差异.
- 重新评估影响阿片类药物处方的文化和医疗实践对于解决阿片类药物流行病至关重要.
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