术后阿片类药物给住院患者进行重大或骨科手术:一项回顾性队列研究,使用来自医院电子处方系统的数据
Yun-Ting Huang1, William G Dixon1,2,3, Terence W O'Neill1,2,3
1Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom.
PloS one
|June 25, 2024
概括
超过70%的大型/整形外科手术患者在住院期间接受了阿片类药物. 改性释放 (MR) 类阿片类药物使用和初始氧化 (IR) 处方显示了有关趋势,突出了对更安全的住院阿片类药物处方实践的需求.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 手术后的阿片类药物管理显著影响患者的结果.
- 住院阿片类药物处方模式难以访问和分析.
- 改变释放 (MR) 的阿片类药物制剂和特定患者群体 (老年人,功能障碍) 存在独特的风险.
研究的目的:
- 评估大手术和骨科手术患者在住院期间的术后阿片类药物使用模式.
- 为了确定使用修改释放 (MR) 类阿片类药物和初始即时释放 (IR) 氧化的使用趋势.
- 评估高剂量阿片类药物处方 (≥50MME/天) 的流行率和阿片类药物处方的释放率.
主要方法:
- 在2010-2021年期间在英国一家教学医院接受重大/骨科手术的患者的回顾性分析.
- 在手术后的前七天内对阿片类药物管理的检查,重点关注最初的48小时.
- 计算每天MR阿片类药物,初始IR氧化和吗啡毫克相当量 (MME) 的比例,以及解禁阿片类药物处方率.
主要成果:
- 71.1%的患者在住院期间接受了阿片类药物治疗,53.3%的患者在阿片类药物治疗后出院.
- 吸收MR阿片类药物使用量从8.7%增加到16.1% (2010-2017年),然后降至11.6% (2021年).
- 在70岁以下的患者中,初始IR氧的使用率从8.3%上升到25.5% (2010-2017年),然后下降到17.2% (2021年);在≥50MME/天的患者中,使用率从13%到22.9%不等.
结论:
- 显著的大多数重大/整形外科手术患者接受住院阿片类药物治疗,观察到高频率的MR阿片类药物和初始IR oxycodone使用.
- 阿片类药物处方模式,包括高剂量MME和放电处方,表明需要提高安全性的领域.
- 这项研究为英国住院患者的阿片类药物使用提供了关键的见解,支持实施更安全的处方指南.
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