术后限制性阿片类药物处方治疗和失禁:一个随机的,非劣势性试验
Angela S Yuan1, Katie A Propst1, James H Ross1
1Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH.
American journal of obstetrics and gynecology
|October 20, 2023
概括
泌尿外科手术后的限制性阿片类药物处方与患者满意度的常规处方一样有效. 这种方法降低了在接受缩和失禁手术的患者中使用阿片类药物的比例.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 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:
- 在妇科手术后,阿片类药物过度处方是常见的,有大量未使用的药物.
- 限制性阿片类药物处方在其他专业中使用,以减轻滥用和转移风险.
- 限制性阿片类药物处方对泌尿外科手术患者的影响尚不清楚.
研究的目的:
- 评估限制性阿片类药物处方方案是否与泌尿后妇科手术患者满意度的常规处方无差.
- 在限制性和标准阿片类药物处方方法之间比较患者对疼痛控制的满意度.
主要方法:
- 一个单中心的,随机的,非劣势性试验,涉及未服用过阿片类药物的患者,接受小或重大泌尿外科手术.
- 患者被随机分配到标准的阿片类药物处方协议或限制性协议 (仅在请求时使用阿片类药物).
- 主要结局是患者在6周后对疼痛控制的满意度,非劣势率为15个百分点.
主要成果:
- 两组患者的满意度都很高,并且在两组中均不低 (92.2%标准对比92.1%限制性).
- 与标准组 (48.4%) 相比,限制性组 (70.8%) 的患者在出院后的前7天没有报告使用阿片类药物.
- 两组之间在阿片类药物处方补充或医疗保健用于疼痛控制方面没有发现显著差异.
结论:
- 限制性阿片类药物处方是一种安全有效的替代方案,可以为泌尿外科手术患者提供常规处方.
- 该协议实现了非劣质的患者满意度,同时可能减少阿片类药物消费.
- 这些发现支持在泌尿后科护理中实施限制性阿片类药物处方,以解决对阿片类药物滥用和转移的担忧.
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