评估处方者遵守皮道外科手术的标准化术后阿片类药物处方协议
Carew Giberson-Chen1, Christina Liu1, Phillip Grisdela1
1Harvard Combined Orthopaedic Residency Program, Harvard Affiliated Hospitals, Boston, MA.
Journal of hand surgery global online
|May 31, 2024
概括
在肘部道手术后的阿片类药物处方协议显示持续变化. 患者最近使用阿片类药物可能会改善坚持,这表明为更好地治疗手术后的疼痛而量身定制的提供者警.
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:
- 阿片类药物流行病促使人们对常见的外科手术程序制定标准化处方协议.
- 阴茎道手术是一种常见的手术,受这些阿片类药物处方指南的约束.
研究的目的:
- 调查影响遵守标准化术后阿片类药物处方协议的患者和程序特定因素.
- 在已建立的指导方针的背景下,分析肘部道手术后的处方模式.
主要方法:
- 追溯对98名接受初级肘部道手术的患者的回顾.
- 排除在18岁以下的患者之外,先前有手术,神经损伤或并发手术.
- 对人口统计,并发症,先前阿片类药物 anamnesis 和手术变量进行双变量统计分析.
主要成果:
- 只有49%的最初阿片类药物处方遵守了协议;26%低于目标,26%高于目标.
- 最近的手术前阿片类药物使用 (3个月内) 与改善的坚持相关.
- 较长的旋转时间和前部转移与较低的粘附度有关,而在位压缩与较高的剂量有关.
结论:
- 管手术的标准化阿片类药物处方协议显示持续的变化.
- 手术前的阿片类药物病史可能表明需要增加提供者的注意力.
- 不同外科手术技术的当前协议目标 (in situ解压与前置) 可能需要重新评估.
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