[在医院处理阿片类药物依赖和戒断问题]
Anne I Dolfing1,2, Paul C D Bank3, C Kees Kramers4
1Noordwest Ziekenhuisgroep, Alkmaar. Afd. Psychiatrie (tevens: GGZ Noord-Holland-Noord).
Nederlands tijdschrift voor geneeskunde
|January 4, 2024
概括
患有高阿片类药物耐受性的患者需要小心剂量,以避免戒断或过量服用. 在监控的环境中,立即高剂量可能是安全的,优先考虑缓解疼痛而不是过量服用的风险.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
背景情况:
- 阿片类药物成导致耐受性,需要更高的剂量.
- 平衡过量风险 (呼吸抑制,QTc延长) 和低剂量 (戒断) 是至关重要的.
- 不准确的患者病史使适当的阿片类药物管理复杂化.
研究的目的:
- 评估在住院期间需要高剂量的阿片类药物耐受性患者的管理.
- 在监控环境中评估立即高剂量阿片类药物启动的安全性和有效性.
主要方法:
- 一个30岁的多种药物使用者,严重依赖甲和海洛因,经过胸部手术后入院.
- 谨慎开始甲,然后由于戒断症状而增加剂量.
- 监测呼吸和心脏功能.
主要成果:
- 最初谨慎的甲剂量导致严重的戒断和疼痛.
- 双倍的甲剂量解决了戒断症状,没有过量服用的迹象.
- 患者的高阿片类药物耐受性得到了成功的管理.
结论:
- 患有高阿片类药物耐受性的住院患者可以安全地接受相当高的阿片类药物剂量,如果受到监测,则可以立即接受.
- 在医院中,戒断和疼痛缓解不足的风险往往超过了过量服用的风险.
- 密切监测呼吸和心律对于安全管理至关重要.
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