在患有脏疾病的患者中使用阿片类止痛药:系统性审查
Shania Liu1,2, Megan B Sands3, Jack W Kerferd4
1The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Camperdown, New South Wales, Australia.
Kidney & blood pressure research
|June 2, 2024
概括
在患有脏疾病的患者中使用阿片类药物的证据有限. 吗啡具有最多的安全数据,而其他阿片类药物需要更大的谨慎,因为对功能障碍的安全性和疼痛缓解的研究不足.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 疼痛管理 疼痛管理
背景情况:
- 类阿片类止痛药经常被处方用于中度至重度疼痛.
- 许多接受阿片类药物治疗的患者表现出功能受损.
- 脏疾病显著影响药物代谢和分泌,需要仔细选择阿片类药物.
研究的目的:
- 系统地审查有关阿片类止痛药在患有脏疾病的成年患者的安全性和止痛疗效的现有证据.
- 评估有关阿片类药物在功能受损的个体中使用的现有数据.
主要方法:
- 在2023年1月26日之前,对八个电子数据库进行了全面搜索.
- 包括的研究是英语原始研究文章,重点关注阿片类药物使用和功能减弱的成年人中的药理动力学.
- 独立的选,数据提取和质量评估由至少两名调查人员进行.
主要成果:
- 该审查包括32项观察性研究.
- 吗啡是研究最多的阿片类药物 (14项研究),其次是芬太尼尔 (3项研究) 和水性吗啡 (2项研究).
- 13项研究检查了其他阿片类药物,包括代因,二代因和布普伦诺芬.
结论:
- 目前,关于阿片类药物在功能障碍中安全性和有效性的证据有限且质量不佳.
- 吗啡证明了对病患者的安全性和疼痛缓解的最可用的证据.
- 建议对其他阿片类药物提高谨慎,对临床结果进行进一步高质量的研究是必不可少的.
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