识别与阿片类药物使用相关的患者特征,以告知外科疼痛管理
Anish K Agarwal1,2,3, Ruiying Xiong1,2, Jeffrey Ebert2
1From the Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA.
概括
年轻的,先前未使用过阿片类药物的患者,疼痛评分较低,使用术后阿片类药物的数量较少. 识别这些患者因素有助于量身定制阿片类药物处方,以尽量减少长期使用和社区浪费.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 有效的手术疼痛管理与负责任的阿片类药物管理之间的平衡是一个重大的临床挑战.
- 确定与阿片类药物使用最小或不使用相关的患者特异性因素对于开发有针对性的处方策略至关重要.
研究的目的:
- 为了确定与低或没有术后阿片类药物使用相关的患者级变量.
- 在手术患者中为量身定制的阿片类药物处方实践提供信息.
主要方法:
- 在一个学术卫生系统进行了前性观察性研究.
- 从2021年5月到2022年2月,通过自动短信从手术患者收集数据.
- 测量的主要结局是术后阿片类药物使用.
主要成果:
- 年龄较小,先前未使用过阿片类药物,以及更低的分泌痛点与低或不使用阿片类药物有关.
- 较高的阿片类药物使用与更多的电话和办公室访问相关,但不是ED访问或入院.
- 调整后的分析表明,年龄较小和未使用过阿片类药物的状态预测了低至零的阿片类药物使用.
结论:
- 年轻的患者,未使用过阿片类药物的人,以及排泄疼痛得分较低的人不太可能使用术后阿片类药物.
- 这些发现使临床医生能够个性化处方阿片类药物,减少长时间暴露和未使用药物的风险.
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
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
Opioid Analgesics: Morphine and Other Natural Cogeners
252
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...
252
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
Opioid Receptors: Overview
879
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
879
General 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


