在术后神经外科患者中表征出院的阿片类药物处方:系统性审查
Megan G Sharpe1, Varun S Shah2, Mina Huerta2
1Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Neurosurgical review
|December 3, 2024
概括
神经外科释放的阿片类药物处方有很大差异,有证据表明过多和过少的处方. 患者特异性疼痛管理至关重要,强调需要在手术后制定更好的阿片类药物使用指南.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 美国面临着阿片类药物滥用流行病,处方阿片类药物对过量死亡有着重大影响.
- 手术后改善恢复方案旨在减少术后阿片类药物使用,但缺乏神经外科指导方针.
- 神经外科的阿片类药物处方实践需要评估以解决潜在的过度处方问题.
研究的目的:
- 评估当前的阿片类药物处方实践在释放的头骨和脊柱神经外科患者.
- 为了确定神经外科医生是否在出院时过度给患者开处方阿片类药物.
- 确定有关神经外科阿片类药物处方最佳实践的文献上的差距.
主要方法:
- 按照PRISMA指南进行了一次系统的文献审查.
- 在PubMed,Cochrane和Embase数据库中进行了搜索.
- 研究量化阿片类药物使用 (例如,药片,吗啡等价物,补充) 被包括在全文审查后.
主要成果:
- 共有23项研究符合纳入标准.
- 经过审查的文献显示了阿片类药物处方的广泛范围,表明了过度和不足处方的趋势.
- 由于变化和缺乏高质量的数据,无法得出关于最佳处方的最终结论.
结论:
- 目前的神经外科释放阿片类药物处方不一致,缺乏标准化指南.
- 非常需要考虑个别患者的疼痛要求.
- 需要更高质量的研究来制定基于证据的指导方针,用于神经外科阿片类药物处方.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
223
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
223
Opioid Analgesics: Morphine and Other Natural Cogeners
183
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
183
Analgesia and Pain Management
504
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
504
Stages of General Anesthesia
369
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
369
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
49
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
49
Discharge Summary Forms
743
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
743


