内阿片类药物在脏移植中的使用:观察性队列研究
Ryan E Hofer1, Charles R Sims1, Patrick G Dean2
1From the Department of Anesthesiology and Perioperative Medicine.
Anesthesia and analgesia
|October 6, 2023
概括
内阿片类药物在移植后显著降低了疼痛和阿片类药物的使用. 然而,这种方法增加了术后恶心和吐 (PONV) 的风险.
科学领域:
- 麻醉学 麻醉学
- 腎臟病學 (nephrology) 是一種醫學.
- 移植手术 移植手术
背景情况:
- 移植在美国是常见的手术.
- 移植后最优的疼痛管理策略还没有很好地定义.
- 内阿片类药物对移植疼痛的疗效被低估了.
研究的目的:
- 评估内阿片类药物给药对移植患者疼痛管理和临床结果的影响.
- 为了比较接受和不接受内阿片类药物的患者之间的阿片类药物需求和疼痛评分.
主要方法:
- 对1014例移植手术 (2017-2022) 的回顾性队列研究.
- 治疗权重的反向概率 (IPTW) 用于比较结果.
- 主要结局:在术后的前72小时内,总体阿片类药物暴露 (MME).
主要成果:
- 静脉内阿片类药物与显著降低72小时术后阿片类药物需求 (30对64MME) 有关.
- 接受内阿片类药物的患者在手术后24小时和72小时报告疼痛得分较低.
- 术后恶心和吐 (PONV) 的发生率增加在吸管内阿片类药物组中观察到 (55%对38%).
结论:
- 内阿片类药物管理改善了疼痛控制,并减少了移植后的阿片类药物消费.
- 必须权衡吸管内阿片类药物的益处与增加PONV风险.
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