术后阿片类药物消费模式在经历创伤和选择性椎脊柱融合的倾向匹配患者之间有所不同
Nicholas B Pohl1, Rajkishen Narayanan1, Yunsoo Lee1
1Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA.
概括
部脊柱创伤患者在手术后使用的阿片类药物比选择性手术患者少. 手术前的阿片类药物使用预测了更高的短期术后消费,表明需要量身定制的护理.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 脊椎手术后长期的阿片类药物治疗是一个重大问题.
- 在创伤性椎脊椎手术患者中阿片类药物使用模式与选择性病例相比仍未得到充分研究.
研究的目的:
- 为了比较经手术后的阿片类药物使用和处方模式,在经历创伤和选择性部脊柱融合的患者之间.
- 为了阐明这些不同患者队伍的疼痛管理策略的差异.
主要方法:
- 追溯性队列研究,对创伤和选择性宫融合患者进行1:1的倾向匹配.
- 对处方药监测计划 (PDMP) 数据的分析,包括阿片类药物,二,肌肉松剂和 gabapentin 的使用.
- 多变量渐进回归以确定术后阿片类药物消费的预测因素 (每天MME).
主要成果:
- 与选择性患者相比,创伤患者在手术前和手术后使用的阿片类药物较少.
- 选择性患者在手术后30天内填写了更多的阿片类药物处方,并且每日MME消费量更高.
- 手术前使用阿片类药物和创伤状况是短期术后MME消费的重要预测因素.
结论:
- 患有创伤的宫融合患者在术后早期消耗的阿片类药物比选择性患者少.
- 手术前使用阿片类药物是短期术后消费增加的关键风险因素.
- 研究结果强调需要个性化术后护理和加强部脊柱创伤患者的随访.
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