处方指南减少了在紧急一般外科手术中术后阿片类药物处方
Elise A Biesboer1, Abdul Hafiz Al Tannir1, Basil S Karam1
1Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
实施一项指导方针,以标准化紧急整体手术 (EGS) 患者的阿片类药物处方,在出院时降低阿片类药物的剂量. 这一举措减少了高剂量的阿片类药物处方,而没有增加患者的补充量,从而提高了患者的安全性.
科学领域:
- 外科手术 手术手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 较高的阿片类药物剂量增加了持续使用,过量服用和死亡的风险.
- 在紧急整体外科 (EGS) 患者中,缺乏针对急性手术疼痛的标准化阿片类药物处方.
研究的目的:
- 评估标准化阿片类药物处方指南对EGS患者的影响.
- 为了确定指导方针的实施是否会在不增加补充量的情况下降低阿片类药物剂量.
主要方法:
- 准实验性研究比较了指导方针实施前后的阿片类药物处方.
- 在指南前和指南后的组中评估患者.
- 主要结局:在出院时,每天接受≥50毫克吗啡等效剂 (MME) 的患者比例.
主要成果:
- 处方的MME中位数从113下降到75 (P=0.03).
- 在出院时每天接受≥50MME的患者比例从75%降至25% (P≤0.01).
- 要求或收到的补充量没有显著增加.
结论:
- 一个标准化的阿片类药物处方指南有效地减少了对EGS患者处方的MME.
- 准则的实施与降低高剂量阿片类药物处方而没有增加补充量有关.
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