在严重受伤和老年创伤患者中进行麻醉药物消费分析
Nicholas G Minner1, Jacob Steiniger2, Siena C Lombardozzi3
1Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.
The American surgeon
|June 13, 2024
概括
多模式疼痛控制 (MMPC) 在严重受伤的创伤患者中显著降低了阿片类药物使用和疼痛评分. 然而,与医生管理的疼痛控制相比,MMPC对晚年创伤患者没有显著的益处.
科学领域:
- 创伤护理 创伤护理
- 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:
- 多模式疼痛管理 (MMPC) 是有效的急性创伤.
- 以前的研究表明,MMPC在创伤患者中减少了阿片类药物的使用.
- MMPC可能会使老年人和严重受伤的人群受益.
研究的目的:
- 评估MMPC在减少阿片类药物消费和疼痛得分方面的有效性.
- 将MMPC与医生管理的疼痛控制 (PMPC) 进行比较.
- 在老年和严重受伤的创伤患者中评估MMPC.
主要方法:
- 追溯性研究比较MMPC和PMPC组.
- 高龄定义为≥55岁;严重受伤为≥15伤害严重程度评分 (ISS).
- 主要结局:每日使用阿片类药物 (MME) 和中位数疼痛得分.
主要成果:
- 严重受伤:MMPC减少了阿片类药物的使用3倍 (30MME/d vs 90.3MME/d) 和疼痛评分 (5/10 vs 6/10).
- 高龄:MMPC和PMPC之间的阿片类药物使用或疼痛评分没有显著差异.
- P值:严重受伤的结果为<0.001;晚年阿片类药物使用的结果为0.974;晚年疼痛得分为0.553.
结论:
- MMPC有效地减少了阿片类药物的消费,并改善了严重受伤的创伤患者的疼痛控制.
- 高龄创伤患者可能需要量身定制的疼痛管理策略.
- 需要进一步的研究来优化老年创伤患者的疼痛管理.
相关概念视频
Analgesia and Pain Management
575
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
575
Opioid Analgesics: Synthetic and Semisynthetic Opioids
275
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
275
Stages of General Anesthesia
415
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
415
Opioid Analgesics: Morphine and Other Natural Cogeners
231
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
231
CNS Depressants: Alcohol and Nicotine
202
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
202
Parenteral Anesthetics: Overview
118
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
118


