从全膝关节和关节整形手术出院后的阿片类药物消费:系统性审查和元分析
Zahra Dawson1, Sofea S Stanton1, Samantha Roy2
1Department of Surgery, Michigan Medicine, Ann Arbor, Michigan; Michigan Opioid Prescribing Engagement Network, Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan.
The Journal of arthroplasty
|February 9, 2024
概括
膝关节和关节置换手术后的阿片类药物处方往往超过患者的消费量. 量身定制处方和使用非阿片类药物止痛药可以改善恢复,并减少与未使用药物相关的风险.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 在全膝关节整形术 (TKA) 和全关节整形术 (THA) 后的术后疼痛往往导致阿片类药物处方.
- 未使用的阿片类药物存在风险,包括滥用和转移.
- 在TKA和THA后患者的阿片类药物消耗仍然不清楚.
研究的目的:
- 为了比较处方阿片类药物的数量与TKA和THA后患者报告的消费.
- 为了识别阿片类药物处方和患者退院后实际使用之间的差异.
主要方法:
- 2015-2022年间发表的研究的系统审查和元分析.
- 在PubMed和Embase数据库中进行了搜索.
- 主要结局:以5毫克的氧化等价物使用阿片类药物;对数据提取和偏差评估的研究进行独立审查.
主要成果:
- 处方阿片类药物超过了TKA (6周内88.4比65.0片) 和THA (12周内64.0比29.8片) 的消费.
- 处方阿片类药物剂量的显著变化:TKA为1.6倍,THA为2.8倍.
- 大多数研究报告疼痛结果 (89%) 和非阿片类药物使用 (72%).
结论:
- 在TKA和THA之后,阿片类药物处方总是超过患者的消费量.
- 根据患者实际需要,制定量身定制的处方指南的建议.
- 强调非阿片类药物,以优化外科康复.
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