手术后新的持续性阿片类药物使用
Razvan Bologheanu1,2, Aylin Bilir1,2, Lorenz Kapral1,2
1Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine, and Pain Medicine, Medical University of Vienna, Vienna, Austria.
JAMA network open
|February 20, 2025
概括
手术后的新持续性阿片类药物使用发生在1.7%的奥地利患者中. 脊柱手术和先前的阿片类药物使用显著增加了这种风险,突出了打击阿片类药物危机的有针对性的干预措施的必要性.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 疼痛管理 疼痛管理
背景情况:
- 手术后的新持续性阿片类药物使用是持续的阿片类药物危机的重要贡献者.
- 关于欧洲人口中手术后新持续性阿片类药物使用的发生率的数据有限.
研究的目的:
- 确定奥地利手术后新持续性阿片类药物使用的发生率.
- 确定与新持续阿片类药物使用风险相关的患者和外科因素.
主要方法:
- 基于人口的回顾性队列研究,使用奥地利国家社会保险数据 (2016-2021年).
- 包括接受一般性,妇科,泌尿器科,骨科和心脏手术的成年患者.
- 通过逻辑回归分析了手术后长达6个月的新持续阿片类药物使用情况.
主要成果:
- 在559,096名患者中,1.7%的患者在手术后出现了新的持续性阿片类药物使用.
- 发病率因手术不同而有所不同,脊柱手术 (6.8%) 和关节塑形手术的发病率更高.
- 以前使用阿片类药物 (OR 3.06) 和特定手术 (脊柱手术 OR 5.36) 等因素是显著的风险因素.
结论:
- 在奥地利,手术后持续使用阿片类药物的发生率低于北美.
- 持续使用阿片类药物的确定的风险因素在不同地区是相似的.
- 需要进一步的研究来比较北美和欧洲环境之间的疼痛管理和医疗保健系统因素.
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