消除延长释放阿片类药物从术后疼痛协议的全膝关节置换患者
Anoush Kalachian1, Judith Barberio2, Jill Cox2
1Englewood Health, Englewood, New Jersey.
概括
在全膝关节置换 (TKR) 患者中消除延长释放 (ER) 类阿片类药物,通过减少抗emetic使用和增加家庭出院,改善了结果. 这项研究支持针对TKR患者的ER阿片类药物的指导方针建议.
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:
- 多模式疼痛管理对于全膝关节置换 (TKR) 患者至关重要.
- 延长释放 (ER) 类阿片类药物通常是术后疼痛治疗方案的一部分.
- 指南建议在某些手术群体中不使用ER阿片类药物.
研究的目的:
- 评估从TKR患者药物中去除ER阿片类药物的影响.
- 为了确定这种变化是否改善了患者的结果.
- 评估对住院时间,疼痛评分和阿片类药物消耗的影响.
主要方法:
- 追溯队列质量改善研究.
- 在协议更改之前和之后对TKR患者 (n=60) 的图表审查.
- 分析结果:停留时间,出院倾向,疼痛评分,抗药使用,阿片类药物剂量和处方.
主要成果:
- 减少了抗药的使用 (p = .03).
- 短暂停留时间的趋势 (p = .33).
- 与康复治疗相比,出院回家的患者数量显著增加 (p < .001).
- 标准化释放阿片类药物处方 (30片,没有补充).
结论:
- 在TKR患者中消除ER阿片类药物与改善结果有关.
- 这种实践变化符合当前的指导方针,并促进了患者的安全.
- 有潜力减少骨科手术中阿片类药物的过度处方和过度消费.
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