手术前使用阿片类药物会预测骨关节炎的初级单侧膝盖或关节整形术后6个月的结果吗? 一个与数据相关的回顾性研究
Furkan Genel1,2, Ian A Harris3,4,5, Natalie Pavlovic5,6
1Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, NSW, 2170, Australia. furkangenel@hotmail.com.
Arthroplasty (London, England)
|March 4, 2024
概括
在接受全膝关节或关节整形手术的患者中,30%的患者在手术前每天服用处方阿片类药物. 这种术前阿片类药物使用没有预测术后并发症或患者报告的结果.
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:
- 有限的澳大利亚研究存在于术前阿片类药物使用及其对结果的影响.
- 在关节切除术前使用阿片类药物的流行率在澳大利亚为16%,在美国为24%.
- 了解这一趋势对于优化患者护理途径至关重要.
研究的目的:
- 确定膝关节整形术 (TKA) 和关节整形术 (THA) 患者使用每日处方阿片类药物的比例.
- 评估手术前阿片类药物使用是否预测6个月的并发症/再入院率.
- 评估手术前阿片类药物使用是否预测患者报告的6个月后的结果.
主要方法:
- 在澳大利亚公立医院接受初级TKA或THA治疗的1,187名患者的回顾性队列研究 (2013-2018).
- 利用从前性收集的数据库中链接的患者级数据.
- 纳入标准:初级骨关节炎诊断,选择性TKA/THA,年龄18岁以上;排除:修复,非选择性,半关节整形,单隔间膝关节整形,先前的骨切除.
主要成果:
- 30%的患者报告定期 (每日) 术前使用阿片类药物.
- 在术前阿片类药物使用和6个月后并发症/再入院率之间没有发现显著的关联.
- 手术前使用阿片类药物与THA患者的与健康相关的生活质量 (EuroQol-VAS) 的降低有关.
- 与患者报告的疼痛,功能或全球感知改善没有显著的关联.
结论:
- 在接受初级TKA/THA治疗的患者中,相当一部分 (30%) 在手术前每天使用处方阿片类药物.
- 在关节整形前使用阿片类药物与术后不良事件或患者报告的关键结果没有相关性,长达六个月.
- 在关节修复手术前使用阿片类药物可能表明潜在的健康状况影响生活质量.
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