与青少年手术后使用阿片类药物相关的因素
Marjorie Odegard1, Shadassa Ourshalimian1, Donia Hijaz1
1Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Surgery, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
Journal of pediatric surgery
|December 14, 2023
概括
年长的青少年,特定的手术,如后脊髓融合,和更高的疼痛在放电预测增加了处方阿片类药物的使用. 了解这些因素可以帮助减少手术后过度处方阿片类药物.
科学领域:
- 青少年医学 青少年医学
- 疼痛管理 疼痛管理
- 外科手术的结果
背景情况:
- 手术后处方阿片类药物的使用是青少年手术的一个重大问题.
- 确定影响阿片类药物消费的因素对于优化疼痛管理和防止滥用至关重要.
研究的目的:
- 确定与手术后青少年处方阿片类药物使用相关的临床和社会人口因素.
- 确定术后使用和未使用阿片类药丸数量的预测因素.
主要方法:
- 一项前性队列研究,涉及119名接受各种手术的青少年 (13-20岁).
- 在手术前和手术后的调查中,评估了临床因素,社会人口统计数据和30天和90天的自我报告的阿片类药物使用.
- 普森回归分析被用来确定与90天阿片类药丸使用相关的因素.
主要成果:
- 后脊髓融合 (PSF) 与最高的阿片类药物使用有关,而桃体切除术的使用率最低.
- 高龄,接受PSF和出院时更高的疼痛分数是增加阿片类药丸使用量的显著预测因素.
- 大多数青少年 (81%) 报告未使用的阿片类药丸,平均剩余20粒.
结论:
- 青少年手术后使用阿片类药物受患者年龄,特定的手术程序和出院时的疼痛水平的影响.
- 基于这些因素的有针对性的策略可以帮助外科医生尽量减少不必要的阿片类药物处方,并减少剩余的药物.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
302
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
302
Opioid Analgesics: Morphine and Other Natural Cogeners
253
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
253
Analgesia and Pain Management
628
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
628
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
88
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
88
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
208
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
208
Parenteral Anesthetics: Overview
130
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
130


