手术后阿片类药物减少方案减少了儿童临床结果的种族差异
David F Grabski1, Rick D Vavolizza1, Heron D Baumgarten2
1University of Virginia School of Medicine, Department of Surgery, Charlottesville, VA, USA.
Journal of pediatric surgery
|October 20, 2023
概括
一项临床阿片类药物减少方案显著减少了儿科手术后疼痛管理中的种族差异,并改善了临床结果. 该协议规范了阿片类药物处方,减少了种族群体在停留时间和输管持续时间上的差异.
科学领域:
- 儿科手术 儿科手术
- 健康 公平 卫生 公平
- 疼痛管理 疼痛管理
背景情况:
- 在儿科外科护理结果方面,种族差异仍然存在.
- 临床方案可以减轻这些差异.
- 对接受腹部手术的婴儿实施了术后阿片类药物减少方案.
研究的目的:
- 确定阿片类药物减少方案是否减少了手术后阿片类药物处方的种族差异.
- 评估该协议对相关临床结果的影响,按种族分层分层.
主要方法:
- 进行了干预前 (2011-2015年) 和干预后 (2016-2021年) 的队列分析.
- 该协议包括静脉注射乙氨基,员工教育和标准化的退出签名.
- 主要结局是术后阿片类药物使用和疼痛评分;次要结局包括临床变量,所有变量都按种族分层.
主要成果:
- 在该协议之前,黑人儿童接受的阿片类药物显著多 (13.1毫克/千克) 比白人儿童 (2.1毫克/千克).
- 在协议后,阿片类药物使用在种族群体之间统计学上是相同的 (0.05 mg/kg vs 0.0 mg/kg).
- 停留时间 (45天与16天) 和输内管持续时间的种族差异在协议后被消除.
结论:
- 阿片类药物减少协议有效地减少了儿科手术后阿片类药物处方的种族差异.
- 该协议还减轻了关键临床结果的种族差异,例如停留时间和输管时间.
- 标准化临床协议可以改善儿科外科护理中的健康公平.
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