开放式或微创手术:新的持续阿片类药物使用的风险
Zayed Rashid1, Selamawit Woldesenbet1, Muhammad Musaab Munir1
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, United States.
概括
最少侵入性手术 (MIS) 与开放式手术 (OS) 相比,大手术后显著降低了新的持续性阿片类药物使用 (NPOU) 的风险. MIS与较少的阿片类药物日和较低的剂量有关,改善了患者的治疗结果.
科学领域:
- 手术瘤学手术瘤学
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 手术后的新持续性阿片类药物使用 (NPOU) 是一个重要的公共卫生问题,影响患者的治疗结果.
- 与外科手术相比,描述NPOU风险对于优化患者护理至关重要.
研究的目的:
- 为了比较开放式手术 (OS) 和微创手术 (MIS) 之间的NPOU风险.
- 分析不同手术过程中的NPOU率,包括肺切除术,胰腺切除术和大肠切除术.
主要方法:
- 在2013-2020年间,使用IBM MarketScan数据库对45757名接受OS或MIS的患者进行了回顾性分析.
- 在未使用阿片类药物患者的手术后180天内,NPOU被定义为2+次阿片类药物补充.
- 多变量逻辑回归用于评估手术方法与NPOU风险之间的关联.
主要成果:
- 总体而言,4.8%的患者出现了NPOU.
- 与OS (5.9%) (P <.001) 相比,MIS与明显较低的NPOU率 (3.6%) 相关.
- 与OS相比,MIS患者的阿片类药物日数较少,总毫克相当剂量较低,NPOU的几率比OS低35%.
结论:
- 最少侵入性手术与手术后新的持续性阿片类药物使用风险降低有关.
- 通过减少阿片类药物消费和缓解长期阿片类药物依赖,MIS提供了好处.
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