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外科医生处方模式和术后风险因素与长期使用阿片类药物后的肩部整形术后的相关
Joshua D Pezzulo1, Dominic M Farronato, Robert Juniewicz
1From the Thomas Jefferson University School of Medicine, Philadelphia, PA (Pezzulo, Farronato, and Juniewicz), and The Rothman Institute at Thomas Jefferson University, Philadelphia, PA (Kane, Kellish, and Davis).
The Journal of the American Academy of Orthopaedic Surgeons
|August 28, 2024
概括
在接受全肩关节整形手术 (TSA) 的患者中,近22%的患者长期使用阿片类药物. 手术前的阿片类药物暴露,二甲的使用和术后的处方模式是TSA后长期使用阿片类药物的关键风险因素.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 阿片类药物流行在美国带来了重大的经济和死亡率挑战.
- 阿片类药物通常用于全面肩关节整形术 (TSA) 后的疼痛管理.
- 了解TSA后的长期阿片类药物使用对于减轻不良结果至关重要.
研究的目的:
- 调查一次性TSA后长期使用阿片类药物的发生率.
- 在TSA患者中确定与长期使用阿片类药物相关的独立风险因素.
主要方法:
- 从2014年至2022年期间对4,488个TSA初级病例进行了回顾性审查.
- 基于术前和术后阿片类药物使用的分层.
- 多变量分析以确定长期使用阿片类药物的风险因素 (定义为术后>30天).
主要成果:
- 22%的患者在TSA后长期使用阿片类药物.
- 手术前的阿片类药物暴露 (OR 6.41) 是最强的风险因素.
- 其他重要因素包括年龄较小,女性性别,非高加索种族,反向TSA,城市居住和使用二.
结论:
- 手术前的阿片类药物暴露是TSA后长期使用的主要驱动因素.
- 手术后的处方和二二类药物的使用也为此做出了重大贡献.
- 外科医生必须优化阿片类药物管理策略,以尽量减少与长期使用相关的风险.
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