腰椎椎间盘切除术后的阿片类药物处方趋势
Albert L Rancu1, Michael J Gouzoulis, Adam D Winter
1From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
腰椎切除术后的阿片类药物处方显示了影响使用的因素. 虽然接受阿片类药物的患者比例略有上升,但在十年内,处方的数量和数量显著下降.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 腰椎间盘切除术是一种常见的外科手术程序.
- 手术后经常给药阿片类药物处方.
- 有关阿片类药物的副作用和滥用存在担忧,促使对处方模式进行调查.
研究的目的:
- 在腰椎切除术后90天内调查阿片类药物处方模式.
- 确定与接受阿片类药物处方和多余的吗啡毫克相当量 (MME) 相关的预测因素.
- 分析随着时间的推移,阿片类药物处方的趋势.
主要方法:
- 对271,631名经过单级腰部拉米内切除/椎间盘切除 (2011-2021) 的患者进行了回顾性分析.
- 排除标准用于确保数据完整性和重点.
- 多变量回归和线性回归分析用于评估预测因素和时间趋势.
主要成果:
- 72.1%的患者被处方阿片类药物.
- 处方阿片类药物与年龄较小,女性性别,更高的并发症指数和地理区域有关.
- 规定的中位数MME从2011年的428.9下降到2021年的225.0.
- 填写处方的平均数量从3.3下降到2.3.
结论:
- 临床和非临床因素影响阿片类药物处方和腰椎间盘切除术后的MME数量.
- 多年来MME和处方数量的显著下降是令人鼓舞的.
- 减少处方补充表明改善了患者的治疗结果,并减少了对阿片类药物的依赖.
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