对于良性与恶性疾病的结直肠切除后的疼痛和阿片类药物使用:单一机构分析分析
Sarah Diaz1, Kara K Brockhaus2, Matthew C Bobel1
1Department of Surgery, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA.
American journal of surgery
|February 16, 2024
概括
结直肠手术后的疼痛和阿片类药物使用在使用增强恢复协议时,对于良性和恶性疾病是相似的. 这些发现表明,非阿片类药物疼痛管理策略对这两种疾病类型都有效.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 疼痛管理 疼痛管理
- 在瘤学瘤学.
背景情况:
- 现有的关于良性与恶性结直肠疾病的阿片类药物需求的研究仍然没有确定性.
- 手术后增强恢复 (ERAS) 途径越来越多地用于结直肠手术.
- 优化疼痛管理对于患者康复和减少阿片类药物依赖至关重要.
研究的目的:
- 为了比较为良性和恶性结直肠疾病进行手术的患者之间的术后疼痛评分和阿片类药物消耗.
- 评估增强恢复疼痛管理途径对这些结果的影响.
主要方法:
- 一个单一机构的分析利用了前性维护的结直肠外科手术数据库.
- 对外科手术期间的数值疼痛评分 (NPS) 和出院时处方的阿片类药物进行了多重回归分析.
- 患者群体被分为良性和恶性疾病类别.
主要成果:
- 该研究包括641名良性组患者和276名恶性组患者.
- 未经调整的分析显示,在良性组中,在手术前和手术后 (0-3天) 的NPS较高.
- 在回归后,两组之间没有发现NPS或放电阿片类药物处方的显著差异,这表明ERAS途径内的两种疾病类型之间有效的疼痛管理.
结论:
- 在使用多式,非阿片类止痛药的增强康复环境中,疼痛和排出阿片类药物的需求在良性和恶性结直肠疾病之间没有显著差异.
- 这表明,标准化,非阿片类药物中心的疼痛管理方案可以有效地满足患者的需求,无论疾病的病因.
- 进一步的研究可能会探索这些队列中的长期疼痛轨迹和患者报告的结果.
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