胃肠道手术后手术后降低阿片类药物消费水平 - 随机试验的系统审查
Matthew G Davey1, William P Joyce1,2
1Department of Surgery, Galway Clinic, Co. Galway H91 HHT0, Republic of Ireland.
Surgery in practice and science
|January 23, 2025
概括
本系统性审查强调了减少手术后阿片类药物使用的方法. 针对阿片类药物的专门咨询和静脉注射在打击全球阿片类药物危机方面显示出有前途.
科学领域:
- 手术瘤学手术瘤学
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 全球阿片类药物危机因手术后阿片类药物处方而加剧.
- 胃肠道手术患者有助于阿片类药物依赖的风险.
- 需要有效的策略来减轻在手术环境中的阿片类毒性.
研究的目的:
- 系统地审查随机对照试验 (RCT),以减少胃肠道手术后的阿片类药物毒性.
- 确定基于证据的方法来降低术后阿片类药物消费.
- 为解决阿片类药物流行病的临床实践和公共卫生倡议提供信息.
主要方法:
- 按照PRISMA指南进行的系统审查.
- 包括随机对照试验 (RCT).
- 风险偏见2.0工具用于质量评估.
主要成果:
- 分析了14个涉及1687名患者的RCT.
- 在83.3%的相关试验中,静脉注射止痛药与在出院时减少的阿片类药物消费有关 (5/6).
- 有限的证据支持口服药物,只有维生素C在一项试验中显示出显著的效果;也注意到了阿片类药物特定咨询和多式联络方法.
结论:
- 具体的阿片类药物咨询和术前静脉注射是减少术后阿片类药物消费的有希望的策略.
- 这些方法可以帮助抵消阿片类药物使用的增加,为全球阿片类药物流行病做出贡献.
- 需要进一步研究多模式疼痛管理.
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