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一项回顾性研究:多模式止痛疗法的质量措施实施和患者结果评估

Noah Lee¹, Jamie Feldt², Carrie Bowman³

¹Johns Hopkins Hospital, Baltimore, Maryland.

|November 21, 2023

概括

非阿片类药物多式止痛,以优点激励支付系统 (MIPS) 477为指导,减少了手术内阿片类药物的使用和最初的术后疼痛. 然而,它没有显著影响排泄疼痛,整体阿片类药物消费,或术后恶心和吐.

科学领域:

麻醉学麻醉学
疼痛管理疼痛管理
卫生政策卫生政策

背景情况:

众所周知,非阿片类药物多模式止痛疗法可以减少阿片类药物消费和术后恶心和吐 (PONV).
基于功绩的激励支付系统 (MIPS) 477对患者结果的影响以前没有被研究过.

研究的目的:

为了评估MIPS 477在非阿片类药物多模式止痛治疗的实施后的患者结果.
评估MIPS 477对妇科手术患者手术后疼痛,阿片类药物消耗和PONV的影响.

主要方法:

对400名经过腹腔镜妇科手术的成年患者进行了回顾性审查.
收集的数据包括患者特征,止痛药,疼痛评分 (PACU到达和出院) 和抗药.
对照组 (n=29) 与实施MIPS 477.7的治疗组 (n=341) 的比较.

主要成果:

治疗组 (MIPS 477) 在PACU到达时显示疼痛得分明显较低 (P = .001).
在治疗组中,整体手术内阿片类药物消耗 (MME) 显著降低 (P = .04).
在PACU排泄疼痛得分,PACU总MME或组之间的PONV中没有观察到统计学上显著的差异.

结论:

实施MIPS 477用于非阿片类药物多模式止痛疗法,有效降低了最初的术后疼痛和手术内阿片类药物给药.
需要进一步的研究来优化MIPS 477协议,以解决分泌疼痛,整体阿片类药物使用和PONV.

关键词:

MIPS 477 质量测量协议多模式止痛药多模式止痛药疼痛评分疼痛评分疼痛评分

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