手术后的阿片类药物逐渐减少及其与患者报告的结果和行为变化的联系:混合方法分析
Benjamin Sands Brooke1,2, Kimberlee Bayless3, Zachary Anderson3
1Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA Benjamin.Brooke@hsc.utah.edu.
Regional anesthesia and pain medicine
|October 21, 2023
概括
手术后的阿片类药物逐渐减少改善了慢性阿片类药物使用患者的疼痛控制和生活质量. 成功的逐渐缩减与疼痛干扰,灾难化,活动,情绪,思维和睡眠的更好结果有关.
科学领域:
- 手术 手术 手术 术 术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 对于慢性阿片类药物使用者来说,建议在手术后逐渐减少阿片类药物,但其对生活质量的影响尚不清楚.
- 患者报告的结果 (PROs) 对于评估逐渐减少对疼痛和行为的影响至关重要.
- 了解这些影响可以为临床实践提供信息,并改善患者的护理.
研究的目的:
- 评估阿片类药物在手术后逐渐减少和患者报告的结果之间的关联.
- 评估逐渐减少对疼痛控制和影响生活质量的行为变化的影响.
主要方法:
- 在VA医疗中心 (2018-2020) 进行的解释性顺序混合方法研究.
- 包括慢性阿片类药物使用的患者,接受各种手术.
- 通过逐渐缩小成功率 (完全,部分,没有) 来分层患者,并进行定性访谈.
主要成果:
- 分析了211名患者,20%的患者完全逐渐缩小,23%的患者部分逐渐缩小,57%的患者没有逐渐缩小.
- 没有减小剂量的组有较高的阿片类药物使用障碍史和排出剂量.
- 与没有缩相比,部分和完全的逐渐缩小显著改善了疼痛干扰和灾难化.
结论:
- 在手术后90天内,部分和完全的阿片类药物逐渐减少与改善疼痛控制有关.
- 成功的逐渐减肥会对影响生活质量的行为产生积极影响,包括活动,情绪,思维和睡眠.
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