术后阿片类药物减少使用多模式疼痛协议门诊整形体育医学外科手术
Ethan M Bernstein1, J Preston Van Buren2, Kieran S M Wolf2
1Department of Orthopaedic Surgery, US Naval Hospital Guam, Agana Heights, Guam, USA.
Orthopaedic journal of sports medicine
|November 21, 2024
概括
在整形体育医学中,一种新的多模式疼痛协议显著减少了43.6%的阿片类药物处方,而没有增加患者的疼痛评分. 这种方法有效地减少了手术后的长期阿片类药物使用.
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:
- 在骨科手术中,阿片类药物是术后疼痛的标准.
- 多模式疼痛管理策略可以减少骨科手术中的阿片类药物处方.
研究的目的:
- 评估整个部门的多模式疼痛协议对减少阿片类药物处方和在整形体育医学中管理术后疼痛的影响.
- 为了分析阿片类药物消费和患者报告的疼痛水平,协议实施后.
主要方法:
- 一项回顾性队列研究比较了骨科体育医学程序的前和后协议组 (每组n=40).
- 程序是根据疼痛水平分层的,每个级别都采用特定的多模式疼痛协议.
- 测量结果包括视觉模拟尺度 (VAS) 疼痛评分在2周,阿片类药物处方量,以及阿片类药物停药的时间.
主要成果:
- 在方案实施后,阿片类药物处方减少了43.6% (方案实施前35.7粒药,方案后20.1粒药,P < .0001).
- 在术后2周没有观察到VAS疼痛得分的显著差异 (2.72前与2.99后,P = .40).
- 2周后继续使用阿片类药物显著下降,在后协议组中只有1名患者,而在前协议组中只有20名患者 (P < .001).
结论:
- 在整形体育医学中实施多模式疼痛协议有效地减少了阿片类药物处方,而不会影响2周的术后疼痛控制.
- 尽管处方减少了,但64.1%的处方阿片类药物被消耗了,这表明可能需要进一步优化以防止过度处方.
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