相关实验视频
Updated: Jul 17, 2025

00:13
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
7.5K
胰腺切除后无阿片类药物排放通过学习健康系统范式
Artem Boyev1, Anish J Jain1, Timothy E Newhook1
1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
JAMA surgery
|September 6, 2023
概括
根据风险分层的胰腺切除术临床途径的代更新显著减少了住院患者和出院的阿片类药物量. 这种学习型医疗系统模型为许多患者实现了无阿片类药物出院,证明了主要癌症手术的可行性.
科学领域:
- 在瘤学瘤学.
- 手术创新 在外科创新.
- 疼痛管理 疼痛管理
背景情况:
- 手术后阿片类药物过度处方有助于持续使用阿片类药物和转移风险.
- 一个学习健康系统 (LHS) 的方法可以减少大手术后的阿片类药物消费.
研究的目的:
- 评估两次代更新对风险分层胰腺切除临床途径 (RSPCPs) 对住院和出院阿片类药物量的影响.
主要方法:
- 一项对832名从2016年至2022年接受胰腺切除的患者的队列研究,分为三个途径版本 (V1,V2,V3).
- 路径更新包括加强教育,限制静脉注射阿片类药物,非阿片类药物捆绑和标准化乘数来计算出院阿片类药物.
- 使用非参数和趋势分析,在通路版本中比较了住院和出院的阿片类药物量 (口服吗啡等价物 - OME).
主要成果:
- 住院患者的整体OME从290毫克 (V1) 降至129毫克 (V3);出院的OME从150毫克 (V1) 降至0毫克 (V3).
- 无阿片类药物出院的百分比从7.2% (V1) 增加到52.5% (V3).
- 在所有队列中,疼痛的中位数仍然很低 (≤3),而离院后补充请求的数量没有增加.
结论:
- 在学习健康系统模型中的反复RSPCP更新在胰腺切除术后显著减少了阿片类药物使用.
- 这种可适应的,无成本的蓝图表明,在重大癌症手术中实现无阿片类药物出院的可行性.
相关概念视频
Chronic Pancreatitis II: Collaborative Care
113
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
113
Appendicitis-II: Diagnostic Studies and Management
98
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
98
Discharge Summary Forms
783
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
783
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
114
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...
114
Opioid Analgesics: Synthetic and Semisynthetic Opioids
333
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...
333
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12

