手术后疼痛轨迹和腹腔镜减肥手术后的阿片类药物需求:单中心历史队列研究
Sinead Campbell1,2, Rachel Chin3, Wai-Man Liu4
1Department of Anesthesia and Pain Management, Toronto Western Hospital, Toronto, ON, Canada.
概括
在减肥手术中优化手术内止痛是关键. 在手术期间有效的疼痛管理可以改善恢复,减少手术后的阿片类药物需求,并改善患者的治疗结果,尽管人们担心阿片类药物的副作用.
科学领域:
- 麻醉学 麻醉学
- 腹部外科 腹部外科
- 疼痛管理 疼痛管理
背景情况:
- 对减肥手术中阿片类药物延迟出现和呼吸抑制的担忧往往导致保守的手术内止痛方法.
- 过于保守的疼痛管理可能会导致严重的术后疼痛和增加阿片类药物需求.
- 这项研究研究了手术内止痛模式及其对腹患者手术后疼痛和恢复的影响.
研究的目的:
- 为了确定腹部外科手术患者手术内止痛药的使用模式.
- 分析手术内止痛和术后疼痛得分以及阿片类药物消费之间的关系.
- 评估早期疼痛控制对以患者为中心的康复结果的影响.
主要方法:
- 进行了一个单中心历史队列研究.
- 从939名腹代谢手术患者 (2018年1月至2019年10月) 的术后数据中提取.
- 研究了手术内干预,PACU疼痛评分,阿片类药物需求和康复结果之间的关联.
主要成果:
- 只有39%的患者在手术内接受长期作用的阿片类药物;非阿片类辅助药物的使用最小.
- 近80%的人在PACU到达时经历了中度至严重的疼痛,其中97%需要救援IV阿片类药物.
- 较低的PACU疼痛分数与减少住院疼痛,较低的阿片类药物使用,更快的出行和更短的住院时间相关.
结论:
- 有效的手术内止痛策略在减肥手术中显著影响早期疼痛控制和患者恢复.
- 应该考虑明智的手术内阿片类药物使用,结合阿片类药物节约多式联络技术.
- 对这种患者群体来说,平衡止痛效益与阿片类药物相关的不良影响至关重要.
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