在初级整部部和膝关节关节整形术后使用阿片类药物,继州范围立法的顺序实施后
Jaquelyn Kakalecik1, Edvinas Sipavicius2, Emilie N Miley1
1Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA.
Arthroplasty today
|January 17, 2024
概括
佛罗里达州的立法规定,在关节和膝盖置换后,阿片类药物处方显著减少. 阿片类药物的使用减少,但没有影响患者的治疗结果,这突显了这些新的处方法规的有效性.
科学领域:
- 整形外科手术 整形外科手术
- 公共卫生政策 公共卫生政策
- 疼痛管理 疼痛管理
背景情况:
- 在全关节整形术 (THA) 和全膝关节整形术 (TKA) 后增加阿片类药物的使用与不良临床结果有关.
- 本研究检查了佛罗里达州立法任务对阿片类药物处方和利用在初级THA和TKA之后的影响.
研究的目的:
- 评估立法任务对阿片类药物处方实践的影响.
- 评估针对新法规的初级THA和TKA之后的阿片类药物使用趋势.
主要方法:
- 651名接受初级TKA或THA治疗的患者 (2018-2020年) 的回顾性审查.
- 根据在强制性处方之前,在7天的处方限期后以及在强制性电子处方后执行的程序来分组患者.
- 多变量分析的差异和千平方测试评估了临床结果,阿片类药物剂量 (MME) 和再录取.
主要成果:
- 平均处方的吗啡毫克相当量 (MMEs) 从规定前的822.3显著下降到7天限制后的465.0 (P < .001) 和电子处方后的228.0 (P < .001).
- 关节整形术的患者接受的MMEs比膝关节整形术的患者少.
- 观察到2.6%的90天再入院率,没有与疼痛相关的再入院.
结论:
- 佛罗里达州的立法任务有效地减少了初级关节整形术后的阿片类药物处方 (MME).
- 阿片类药物利用率下降,但没有对患者的治疗结果产生负面影响,即使出现了通行手术的趋势.
- 调查结果强调了立法行动和外科手术对骨科阿片类药物处方的联合影响.
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