在阴茎道手术后救援阿片类药物处方的危险因素
Carew Giberson-Chen1, Christina Liu1, Phillip Grisdela1
1Harvard Combined Orthopaedic Residency Program, Harvard Affiliated Hospitals, Boston, MA, USA.
概括
大多数患者在肘部道手术后不需要额外的阿片类药物处方. 然而,那些患有慢性疼痛或疼痛敏感综合征的人可能需要额外的疼痛管理策略.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 阿片类药物流行需要仔细审查术后阿片类药物处方.
- 阴茎道手术是一种常见的骨科手术.
- 了解额外的阿片类药物处方的风险因素至关重要.
研究的目的:
- 为了确定患者和手术特异性风险因素,用于额外的阿片类药物救援处方后肘部道手术.
主要方法:
- 在两个学术医疗中心对274名接受肘部道手术的患者进行了回顾性审查.
- 收集的数据包括人口统计,并发症,先前的阿片类药物病史和手术变量.
- 使用统计分析 (单变量和双变量) 来确定风险因素.
主要成果:
- 8%的患者需要额外的术后阿片类药物救援处方.
- 与救援阿片类药物需求增加相关的因素包括女性性别,纤维肌痛,慢性阿片类药物使用,慢性疼痛诊断和最近的阿片类药物使用.
- 中位数的阿片类药物处方量因手术技术而异 (in situ与前置转移).
结论:
- 患有慢性疼痛或疼痛敏感综合征的患者有更高的风险需要额外的阿片类药物后阴茎道手术.
- 对于高风险患者,建议在术后疼痛管理方面进行多学科团队合作.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
299
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...
299
Analgesia and Pain Management
623
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...
623
Opioid Analgesics: Morphine and Other Natural Cogeners
250
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...
250
Prescription, Nonprescription and Orphan Drugs
728
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
728
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
84
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...
84
Skeletal Muscle Relaxants: Adverse Effects
372
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
372


