在倾向性得分匹配模型中,手术前使用大麻在初级膝关节关节整形术后没有增加阿片类药物的使用
Simarjeet Puri1, Christian Ong1, Yu-Fen Chiu2
1Adult Reconstruction and Joint Replacement, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
HSS journal : the musculoskeletal journal of Hospital for Special Surgery
|September 16, 2024
概括
在全膝关节整形术 (TKA) 后,手术前使用大麻并没有显著改变阿片类药物的消费. 这项研究发现,在TKA手术后,大麻使用者与非使用者相比,没有增加住院或门诊阿片类药物的使用.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 娱乐和医用大麻使用日益流行.
- 在全膝关节整形术 (TKA) 后,关于大麻对术后疼痛和阿片类药物消费的影响的有限数据.
研究的目的:
- 评估手术前使用大麻和手术后使用阿片类药物之间的关联.
- 评估大麻使用对TKA后出院后阿片类药物处方的影响.
主要方法:
- 对接受骨关节炎初级TKA治疗的患者的回顾性分析.
- 根据临床和人口统计因素,现有大麻使用者与非使用者的倾向性得分匹配 (1:6).
- 在匹配的队列中比较住院和门诊阿片类药物消费 (MME) 和住院时间.
主要成果:
- 大麻使用者和非使用者之间的住院 (每小时,每天,总) 或门诊阿片类药物消费 (MME) 没有显著差异.
- 在两组中观察到类似的住院时间.
- 匹配的队列包括70名大麻使用者和420名非使用者.
结论:
- 手术前使用大麻并没有独立增加TKA后的阿片类药物需求.
- 研究结果表明,大麻使用可能不是TKA后手术后阿片类药物消费的重要因素.
- 建议进行进一步的前性研究来证实这些发现.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
251
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
251
Analgesia and Pain Management
552
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
552
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
204
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
204
General Anesthesia: Overview
198
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
198
Opioid Analgesics: Morphine and Other Natural Cogeners
192
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
192
Parenteral Anesthetics: Overview
111
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
111


