人工尿道管放置后持续使用阿片类药物:一个大索赔数据库分析分析
Ryan J Davis1, Marissa Maas2, David Ginsberg2
1Keck School of Medicine of the University of Southern California, Los Angeles, CA.
Urology
|October 18, 2024
概括
在人工泌尿器 (AUS) 植入后手术后的阿片类药物处方显著增加了持续使用阿片类药物的风险. 这些处方并没有减少急诊室或门诊诊所的访问,强调了需要使用阿片类药物节省疼痛管理策略的需要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 疼痛管理 疼痛管理
- 药物监督 药物监督 药物监督
背景情况:
- 人工泌尿关节 (AUS) 植入是一种需要术后疼痛管理的手术程序.
- 使用阿片类药物用于术后疼痛控制是常见的,但存在依赖和不良事件的风险.
- 了解AUS安置后阿片类药物使用的长期后果对于患者安全至关重要.
研究的目的:
- 评估术后阿片类药物处方和AUS植入后持续使用阿片类药物之间的关联.
- 评估术后阿片类药物使用对急诊室 (ED) 和AUS手术后办公室/门诊诊所的影响.
- 在AUS植入的背景下,确定对阿片类药物节约性疼痛管理策略的需求.
主要方法:
- 使用了全国性的索赔数据库 (TriNetX美国协作网络),涵盖了超过1.15亿名患者.
- 确定了在2010-2024年期间首次接受AUS安置的男性,并应用了特定的排除标准.
- 倾向性得分匹配用于比较接受或不接受术后阿片类药物的队列,控制各种患者特征和诊断.
主要成果:
- 在AUS手术后的阿片类药物处方 (氧化,水化或编解) 与持续阿片类药物使用风险增加三倍 (15.15%与4.92%相比).
- 持续使用阿片类药物的风险观察到在手术后3-9个月之间 (风险比率=3.08).
- 在接受术后阿片类药物治疗的患者中,没有发现ED或办公室/门诊访问风险的显著降低.
结论:
- 在AUS植入后处方常见的阿片类药物会增加长期阿片类药物使用的风险.
- 在AUS手术后使用阿片类药物似乎不会降低后续ED或门诊访问的可能性.
- 这些发现强调了为接受AUS安置的患者采用阿片类药物节约性疼痛管理方法的重要性.
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