在接受全膝关节关节整形手术的患者中比较阿片类药物教育的模式:一项随机试验试验
Miriam Sheetz1, Angela Puglisi1, Mark Trentalange1,2
1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA.
Regional anesthesia and pain medicine
|September 26, 2024
概括
膝关节整形术患者往往缺乏阿片类药物知识. 这项试点研究发现,面对面或视频教育在治疗术后疼痛和减少阿片类药物补充方面与网络研讨会同样有效.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 医学教育 医学教育
背景情况:
- 接受全膝关节整形术 (TKA) 的患者经常经历明显的术后疼痛,需要使用阿片类药物.
- 关于适当使用和处理这些强效药物的知识差距往往存在.
- 教育干预措施可以改善疼痛控制,并加强适当的阿片类药物使用.
研究的目的:
- 为了比较基于网络研讨会的标准教育的有效性与针对阿片类药物使用和TKA后疼痛控制的新型面对面和视频教育干预措施.
- 评估不同教育格式对阿片类药物补充请求,疼痛评分和患者知识的影响.
主要方法:
- 一项前性随机试点研究,涉及42名TKA患者.
- 患者被分配到三个组:标准网络研讨会,面对面的教育或视频教育.
- 主要结局包括手术后30日和60日的阿片类药物补充请求;次要结局评估疼痛评分,阿片类药物消耗和药物知识.
主要成果:
- 对于阿片类药物补充请求,数值评分表 (NRS) 疼痛评分或口服吗啡等效 (OME) 消费,在两组之间没有发现显著差异.
- 在所有组中,阿片类药物补充请求都很低 (POD 30的0-16.7%,POD 60的0-8.3%).
- 平均NRS疼痛评分保持在5以下,平均每日OME摄入量在术后第7天为14或以下.
结论:
- 所有的教育干预措施,包括网络研讨会,面对面和视频格式,对于术后疼痛管理和TKA后阿片类药物使用同样有效.
- 患者通常经历了最小的阿片类药物补充请求,表明成功控制疼痛.
- 这项试点研究表明了招聘和保留的可行性,强调了需要更大规模的,强大的试验来检测潜在的差异.
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