术后阿片类药物消费在同时或分阶段双边全膝关节关节整形术后更大
Sara J Sustich1, Jeffrey B Stambough2, Ryan Hui2
1Department of Orthopedic Surgery, University of Oklahoma, Oklahoma City, Oklahoma.
The journal of knee surgery
|October 18, 2023
概括
同时双边全膝关节整形手术 (simBTKA) 与分阶段双边全膝关节整形手术 (stgBTKA) 相比,并没有显著减少阿片类药物消费. 两种程序都显示了类似的月度阿片类药物使用率,simBTKA患者获得更大的初始处方.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 在全膝关节整形术 (TKA) 后暴露于阿片类药物增加了依赖的风险.
- 在双边TKA中优化阿片类药物使用对于患者的康复和安全至关重要.
研究的目的:
- 为了比较同时双边全膝关节整形手术 (simBTKA) 和分阶段双边全膝关节整形手术 (stgBTKA) 之间的阿片类药物消费.
- 为了确定simBTKA是否与stgBTKA相比降低了整体阿片类药物需求.
主要方法:
- 对29名simBTKA患者和50名阿片类药物未使用的stgBTKA患者的回顾性审查.
- 使用国家处方数据库分析手术后的阿片类药物补充和吗啡毫克相当剂 (MMEs).
- 初始MME处方在出院时和手术后6个月的MME总消费量之间的比较.
主要成果:
- simBTKA组获得的初始MME处方 (中位数375) 比stgBTKA (中位数300) 更大.
- 在前30天,simBTKA的MME消费量较高 (中位数为300),而stgBTKA (中位数为0).
- 在simBTKA (中位数675) 的6个月MME消费总量高于stgBTKA (中位数450),尽管每月的消费率相似.
结论:
- 与stgBTKA相比,simBTKA并没有显著降低整体阿片类药物消费.
- simBTKA患者在手术后立即和30天后接受了更大的阿片类药物.
- 进一步的研究可能会探索双边膝关节关节整形手术的替代疼痛管理策略.
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