大麻使用史对腰部融合患者手术后使用阿片类药物的影响:一项美国回顾性研究
Pranav Mirpuri1, Syed Ibad Khalid2, Patrick King1
1Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Asian spine journal
|October 22, 2024
概括
患有大麻使用史的患者在腰部融合手术后的术后阿片类药物利用率降低. 这表明考虑大麻使用模式,以量身定制的疼痛管理策略.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 大麻素研究 研究 大麻素研究
背景情况:
- 对脊柱手术疼痛而言,阿片类药物处方是常见的.
- 尽量减少阿片类药物剂量和慢性使用是一个关键的需要.
- 大麻使用很普遍,其对手术疼痛的影响正在调查中.
研究的目的:
- 调查大麻使用史和术后阿片类药物使用之间的关联.
- 在接受腰部融合手术的患者中分析阿片类药物使用模式.
- 为了确定大麻使用是否会影响手术后需要高剂量的阿片类药物.
主要方法:
- 对153,500名患者进行一至三级腰部融合的回顾性队列研究 (2012-2021年).
- 倾向性得分匹配创造了匹配的大麻使用者和非使用者的队列.
- 在手术后的2个月和6个月评估了阿片类药物的利用 (吗啡每天毫克相当量) 和过度使用.
主要成果:
- 1216名患者被匹配到大麻使用者和非使用者队列中.
- 大麻使用者在2个月 (41.1%对47.7%) 和6个月 (37.7%对46.2%) 的阿片类药物使用率较低.
- 大麻使用者在早期术后期使用高剂量的阿片类药物 (≥100MME/天) 的比例明显较低 (3.79%对6.91%).
结论:
- 大麻使用史与腰部融合后手术后阿片类药物使用的减少有关.
- 大麻使用者在手术后的立即阶段减少了高剂量的阿片类药物消费.
- 临床医生应考虑患者的大麻使用史,以便在脊椎手术后进行个性化疼痛管理定位.
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