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慢性处方阿片类药物的使用者在减肥手术后的头12个月内减少
Enoch J Abbey1, Richard D Nudotor2, Banda A A Khalifa3
1NYC Health + Hospitals/Harlem, Columbia University Medical Center, New York, New York, USA.
Obesity (Silver Spring, Md.)
|December 5, 2024
概括
腹部外科手术减少了近25%的慢性阿片类药物使用,但一些患者在手术后增加了阿片类药物的剂量. 建议进行进一步的研究,并减少手术前的剂量.
科学领域:
- 腹腔外科手术是什么意思
- 疼痛管理 疼痛管理
- 片类药物使用障碍.
背景情况:
- 肥胖是慢性疼痛的一个重要危险因素.
- 阿片类药物通常用于慢性疼痛管理.
- 减肥手术是一种有效的减肥干预措施.
研究的目的:
- 调查Roux-en-Y胃绕道 (RYGB) 和垂直袖胃切除术 (VSG) 对慢性阿片类药物处方使用的影响.
- 为了比较不同减肥手术后的阿片类药物停用和剂量变化.
主要方法:
- 来自IBM MarketScan数据库 (2010-2017) 的成年慢性阿片类药物使用者的分析,他们接受了减肥手术.
- 在手术前和后的6个月期间,以吗啡毫克相当量 (MME) 测量阿片类药物使用量.
- 在RYGB和VSG组之间以及与手术前水平相比,MME变化的比较.
主要成果:
- 近25%的患者在手术后12个月内停止服用阿片类药物,VSG和RYGB的比例相似.
- 手术前的阿片类药物暴露没有预测停药,但多种处方类型与较低的戒断率有关.
- 在持续使用者中,RYGB和VSG患者的平均MME在手术后增加.
结论:
- 腹腔外科手术显著减少了慢性阿片类药物使用者的数量.
- 一部分患者经历了手术后增加的阿片类药物暴露,需要长期监测.
- 医疗保健提供者应就潜在风险向患者提供咨询,并考虑在手术前减少阿片类药物剂量.
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