在剖腹产后优化阿片类药物处方量:一项随机对照试验
Marcela C Smid1, Rebecca G Clifton, Kara Rood
1Departments of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, The Ohio State University, Columbus, Ohio, University of Pennsylvania, Philadelphia, Pennsylvania, University of Pittsburgh, Pittsburgh, Pennsylvania, University of Alabama at Birmingham, Birmingham, Alabama, Brown University, Providence, Rhode Island, Columbia University, New York, New York, University of Texas Medical Branch, Galveston, Texas, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Northwestern University, Chicago, Illinois, and University of Texas at Austin, Austin, Texas; the Department of Anesthesiology, Columbia University, New York, New York; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
一个个性化阿片类药物处方协议 (IOPP) 与共享决策有效地管理了剖腹产后疼痛. 与固定数量相比,这种方法减少了处方阿片类药片的数量,而不会影响母亲的疼痛缓解.
科学领域:
- 产科和妇科 产科和妇科
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 剖腹产后疼痛管理通常涉及固定数量的阿片类止痛药.
- 需要个性化的方法来优化疼痛缓解和减少阿片类药物暴露.
- 共享决策 (SDM) 具有量身定制治疗计划的潜力.
研究的目的:
- 为了评估与SDM的个性化阿片类药物处方协议 (IOPP) 是否与固定数量的阿片类药物治疗剖腹产后疼痛不逊色.
- 评估IOPP与SDM对剖腹产后阿片类药片使用的影响.
主要方法:
- 一个多中心,随机控制的非劣势性试验,将IOPP与SDM与固定数量的 (20片) 氧化进行比较.
- 没有并发症的剖腹产的参与者 (n=5,521) 被随机分配为1:1.
- 主要结局在出院1周后是中度至严重的疼痛 (BPI评分≥4).
主要成果:
- 治疗SDM的IOPP在出院1周后的治疗疼痛的固定量不低于固定量 (59.5%对60.1%).
- 在产后90天内,IOPP组的阿片类药片数量显著减少 (中位数为14对20) (P <.001).
- 在个性化方案下,没有观察到剖腹产后疼痛管理的妥协.
结论:
- 个性化阿片类药物处方协议与共享决策是一个安全有效的策略,用于剖腹产后止痛.
- 这种方法导致减少阿片类药物处方,而不会对疼痛控制产生负面影响.
- 在阿片类药物处方中的SDM可以优化患者护理,并可能减轻与阿片类药物使用相关的风险.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Opioid Analgesics: Morphine and Other Natural Cogeners
Analgesia and Pain Management
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...


