在骨骨折的开放缩减和内部固定后使用阿片类药物
Albert L Rancu1, Andrew Salib1, Alexander J Kammien1
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine.
The Journal of craniofacial surgery
|November 27, 2024
概括
对下骨折的阿片类药物处方从2011年到2021年有所减少. 年龄和先前的阿片类药物使用与较高的阿片类药物含量有关,这表明疼痛管理实践的演变.
科学领域:
- 面外科手术 面外科手术
- 疼痛管理 疼痛管理
- 阿片类药理学阿片类药理学
背景情况:
- 骨折是常见的伤害,需要手术干预.
- 手术后疼痛管理通常涉及阿片类止痛药,引发了对滥用的担忧.
- 了解阿片类药物处方模式对于患者安全和负责任的药物使用至关重要.
研究的目的:
- 分析下骨折手术治疗后90天阿片类药物处方趋势.
- 确定与阿片类药物使用增加 (MME) 相关的患者特异性因素.
- 评估十年 (2011-2021) 间阿片类药物处方的变化.
主要方法:
- 对15049名接受底骨折开放缩小和内部固定治疗的患者 (2011-2021) 的回顾性分析.
- 数据来源于PearlDiver Mariner165数据库,使用了特定的排除标准.
- 多变量回归确定了与阿片类药物处方填充和过量的MME相关的因素.
- 简单的线性回归分析了随时间推移的处方模式.
主要成果:
- 69%的患者填写了阿片类药物处方.
- 增加的MMEs与年龄较大,先前的阿片类药物使用和慢性疼痛史 (P <0.01) 有关.
- 片类药物处方率从73.3% (2011) 降至61.9% (2021),中位数MME和处方数量减少.
结论:
- 年龄和先前存在的风险因素显著影响了下骨折患者中MME利用率.
- 观察到的阿片类药物处方和MME的减少表明了改善的临床实践.
- 对面创伤的非阿片类药物疼痛管理策略进行进一步的研究是有必要的.
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