在接受骨科康复治疗的老年患者中使用非阿片类止痛药
Aaron J Bilek1,2,3, Stephanie Cullen1,4, Carolyn M Tan1,2
1Division of Geriatric Medicine, Sinai Health, Toronto, Canada.
概括
在住院骨科康复 (IOR) 期间,老年人使用的非阿片类止痛药 (NOA) 较少. 这凸显了为这个脆弱人群量身定制的多式联络止痛 (MMA) 方案的需要.
科学领域:
- 疼痛管理 疼痛管理
- 老年医学 老年医学
- 康复医学 康复医学 康复医学
背景情况:
- 多模式止痛药 (MMA) 将阿片类药物与非阿片类止痛药 (NOA) 结合起来,以减少与阿片类药物相关的不良事件.
- 虽然在外科骨科护理中是标准的,但对于常年老年和脆弱的住院骨科康复 (IOR) 患者的MMA指导不太清楚.
- 在IOR人群中NOA使用的研究是有限的.
研究的目的:
- 描述非阿片类止痛药 (NOA) 在住院骨科康复 (IOR) 期间在老年人与年轻人的处方模式.
- 为了确定NOA在老年IOR人群中处方的预测因素.
主要方法:
- 追溯的病例控制研究.
- 包括在2019年11月至2021年6月期间因骨科指标入院的50岁以上的患者.
- 在老年人 (≥50) 和年轻人 (<65) 之间比较NOA处方,并在老年队列中确定了预测因素.
主要成果:
- 在643个IOR患者接触中,48.2%涉及NOA使用.
- NOA的处方与年轻年龄 (OR:0.97) 和之前使用NOA (OR:3.15) 有显著的关联.
- 与NOA处方相关的其他因素包括更高的BMI,精神病史,选择性手术和转诊来源. 在NOA使用者和非使用者之间,不良事件是相似的.
结论:
- 非阿片类止痛药 (NOA) 的处方是异质的,在住院骨科康复 (IOR) 中随着年龄的增长而减少.
- 这表明有机会专门为老年IOR患者开发NOA集成的,节省阿片类药物的MMA协议.
- 需要进一步的研究来评估这些定制方案的安全性和有效性.
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