手术前和手术后的阿片类药物处方和美国年轻人的长期阿片类药物补充
Tori N Sutherland1,2,3, Jennifer A Rabbitts4, Gregory E Tasian5,6
1Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia (CHOP), University of Pennsylvania Perelman School of Medicine, Philadelphia.
JAMA network open
|July 5, 2024
概括
对于接受手术的美国年轻人来说,大约六分之一的阿片类药物处方在手术前被填充,而33分之一的药物处方在91-180天后被重新填充,这表明新的持续性阿片类药物使用. 这些高风险的做法需要注意.
科学领域:
- 公共卫生 公共卫生
- 儿科手术 儿科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 高风险的阿片类药物处方做法,例如在没有指示的情况下在手术前开处方,在美国年轻人中并未得到充分理解.
- 这些做法可能有助于在青少年中发展新的持续性阿片类药物使用.
研究的目的:
- 为了描述阿片类药物处方模式的变化,在阿片类药物未使用的美国年轻人手术后的180天内包括补充之前,之后和包括补充.
- 为了确定与手术后新的持续阿片类药物使用相关的因素.
主要方法:
- 一项回顾性队列研究,利用2015-2020年国家索赔数据.
- 包括11至20岁的未使用过阿片类药物的青少年,接受了22种特定的住院和门诊外科手术手术.
- 多变量后勤回归分析了处方时间和长时间补充 (新持续阿片类药物使用的代理) 之间的关联.
主要成果:
- 在100,026名未曾使用过阿片类药物的年轻人中,16.2% (7,587) 在手术前1-14天完成了最初的阿片类药物处方.
- 13.8% (6,467) 在手术后30天内补充了第二份处方,3.0% (1,216) 在手术后91-180天重新补充.
- 手术前的分发,年龄较大以及通常不会引起严重疼痛的程序与新的持续性阿片类药物使用有关.
结论:
- 尽管阿片类药物开放量有所下降,但很大一部分青少年在手术前接受了处方药,显著的百分比呈现出新的持续性阿片类药物使用.
- 调查结果突出了政策干预和临床沟通的必要性,该干预需要针对接受手术的青少年处方阿片类药物.
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