在手术前的阿片类药物使用和手术后的结果,在患者接受微血管减压三角神经疼痛的患者
Anita L Kalluri1, Emeka Ejimogu1, Collin Kilgore1
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore , Maryland , USA.
Neurosurgery
|March 14, 2024
概括
在接受微血管减压 (MVD) 的三角神经疼痛 (TN) 患者手术前使用阿片类药物与更严重的疼痛和更高的复发率有关. 在MVD手术之前,建议在TN处方阿片类药物时谨慎使用.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 临床结果研究研究
背景情况:
- 三神经疼痛 (TN) 管理涉及有争议的阿片类止痛药的使用.
- 术前阿片类药物使用对TN患者微血管减压 (MVD) 结果的影响仍然未报告.
研究的目的:
- 调查手术前阿片类药物消费与手术后结局在经历MVD的TN患者之间的关联.
主要方法:
- 对接受MVD的920名TN患者 (2007-2020年) 的回顾性审查.
- 患者被分为使用阿片类药物和不使用阿片类药物组.
- 分析包括人口统计数据,并发症,TN特征,疼痛/麻木结局,并使用多变量回归和生存分析复发.
主要成果:
- 15.8%的患者在手术前使用了阿片类药物.
- 手术前的阿片类药物使用者更年轻,吸烟率更高,经历了更糟糕的疼痛评分和MVD后更高的复发率.
- 阿片类药物使用独立预测了手术后疼痛的恶化和复发风险的增加.
结论:
- 在TN患者中,手术前使用阿片类药物与MVD后的疼痛结果较差和复发风险较高有关.
- 建议对TN进行明智的阿片类药物处方,考虑到对MVD后结果的潜在负面影响.
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