出院后的术后阿片类药物消费:密歇根外科质量协作注册表的最新情况
Ashwin J Kulkarni1,2, Vidhya Gunaseelan2,3, Chad M Brummett2,3
1From the University of Michigan Medical School, Ann Arbor, MI.
概括
基于密歇根外科质量协作 (MSQC) 数据的更新的阿片类药物处方指南,导致患者在许多手术过程中减少了阿片类药物的消费. 这些更新的指南旨在平衡疼痛管理与减少阿片类药物滥用.
科学领域:
- 改善外科手术的质量.
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 类阿片类止痛药通常用于中度至重度的术后疼痛.
- 过度的阿片类药物处方与阿片类药物利用率的增加和潜在的滥用有关.
- 患者报告的数据对于完善阿片类药物处方实践至关重要.
研究的目的:
- 在四年内使用密歇根外科质量协作 (MSQC) 登记册评估21项外科手术中的阿片类药物消耗.
- 根据当前的患者消费数据,更新出院后的阿片类药物处方指南.
- 为了比较患者报告的阿片类药物消费在指南实施之前和之后.
主要方法:
- 来自MSQC注册表 (2018年1月-2021年10月) 的未使用过阿片类药物的成年外科患者数据的分析.
- 主要结局:患者报告的阿片类药物消费 (氧化5毫克相当).
- 根据第75个百分位数的消费,参考先前数据 (2018年1月 - 2019年5月) 更新的指南.
主要成果:
- 39493名未曾服用阿片类药物的患者被纳入分析.
- 对于7种常见的手术,指南保持不变;对于9种手术,建议范围下降 (大多数为5片).
- 为5种手术制定了新的指导方针,所有上限均为10片或更少.
结论:
- 与2018-2019年相比,患者报告的阿片类药物消费在2018-2021年期间普遍下降.
- 为优化疼痛控制和最大限度地减少处方危害,针对许多程序实施了更新的指导方针.
- 该研究强调了数据驱动的指导方针更新在治疗术后阿片类药物使用的有效性.
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