在某些耳鼻喉外科手术中术后纳洛的作用
Natalie M Perlov1, Sohan S Shah1, Joann Bluj1
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
概括
手术后纳洛没有显著影响新物质使用障碍 (SUD),过量服用或耳鼻喉手术后死亡. 伴随性疾病是疼痛管理决策的关键因素.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 药物使用障碍 (SUD) 和过量服用是严重的公共卫生问题.
- 耳鼻喉科手术包括各种各样的手术,每个手术都有独特的术后护理需求.
- 纳洛是一种用于逆转过量服用的阿片类药物抗剂,但其在预防新SUD手术后的作用仍在调查中.
研究的目的:
- 评估术后纳洛处方与新物质使用障碍 (SUD),过量服用和死亡的发生率之间的关联.
- 为了在各种耳鼻喉科手术后的6个月内分析这些结果.
- 在耳鼻喉科中为术后疼痛管理策略提供信息.
主要方法:
- 使用TriNetX数据库进行回顾性队列研究.
- 包括在2003年至2023年期间接受特定耳鼻喉手术的成年患者.
- 排除了先前存在的SUD或过量服用的患者,以及在6个月的随访期间内进行了额外手术的患者.
主要成果:
- 分析了一大批超过230万名患者的队列.
- 最初的分析显示,在匹配之前,各种关联存在.
- 在对人口统计学变量和并发症 (例如,其他物质使用,精神疾病) 进行控制后,术后纳洛与新的SUD,过量服用或死亡之间的关联显著减少 (P > .01).
结论:
- 手术后的纳洛可能不会显著影响新的SUD的发展,或者在特定的耳鼻喉手术中发生过量和死亡事件.
- 预先存在的SUD和精神疾病是术后疼痛管理中需要考虑的关键因素.
- 关于纳洛使用的临床决策应考虑到患者的并发病症.
相关概念视频
01:24Parenteral Anesthetics: Overview
129
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.
129
01:24General Anesthesia: Overview
220
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
220
01:22Stages of General Anesthesia
451
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
451
01:13Local Anesthetics: Pharmacokinetics
764
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
764
01:26Endoscopic 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
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
636
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
636