在心脏外科手术中预测术后吗啡毫克相当量的预测因素
David Delijani1, Hyungjoo Kim1, Xueqi Huang2
1Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital, Northwell Health, Manhasset, NY.
Journal of cardiothoracic and vascular anesthesia
|September 11, 2024
概括
需要更多阿片类药物的心脏手术患者包括那些接受冠状动脉旁路移植 (CABG) 的患者,肝病患者或使用患者控制的止痛药. 年龄较小和BMI较高也增加了阿片类药物需求.
科学领域:
- 麻醉学 麻醉学
- 心胸外科手术 心胸外科手术
- 疼痛管理 疼痛管理
背景情况:
- 心脏手术后使用阿片类药物很常见,并与短期和长期不良影响有关.
- 减少术后阿片类药物止痛是一种日益增长的临床重点.
- 确定增加阿片类药物消费的风险因素对于制定阿片类药物节约策略至关重要.
研究的目的:
- 确定与成人心脏手术患者术后阿片类药物需求增加相关的风险因素.
- 为了告知患者特异性,阿片类药物节约性疼痛管理方案的发展.
主要方法:
- 在一个学术医疗中心对电子医疗记录和胸部外科医生协会数据库的回顾性分析.
- 包括接受开放心脏手术的成年患者,但不包括持续静脉注射麻醉剂或手术死亡率的患者.
- 使用阿片类药物 (手术后的0-3天) 量化为吗啡毫克相当量 (MME).
主要成果:
- 这项研究包括1604名患者,1066人接受了冠状动脉旁路移植 (CABG).
- 在CABG接受者 (31.0%),肝病患者 (76.3%) 和使用患者控制止痛药 (48.8%) 的患者中观察到MME增加.
- 年轻的年龄和更高的体重指数 (BMI) 也与更高的MME有显著的关联.
结论:
- 冠状动脉旁路移植 (CABG),肝病,患者控制的止痛,年龄较小和BMI较高是与术后阿片类药物使用增加相关的关键因素.
- 这些发现支持在风险患者群体中考虑更积极的,多式联络,阿片类药物节约的术后治疗方案.
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