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患有阿片类药物依赖的个体的手术性流产:患者的特征和疼痛经验
Kari P Braaten1, Alisa B Goldberg1, Isabel R Fulcher2
1Planned Parenthood League of Massachusetts, Boston, MA, United States; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States.
Contraception
|April 18, 2025
概括
经过手术性流产的阿片类药物依赖者报告疼痛得分较高,但在静脉注射中度镇静后也会出现类似的疼痛缓解. 这表明这些患者不应该限制镇静剂,改善他们的堕胎经验.
科学领域:
- 生殖健康 生殖健康
- 疼痛管理 疼痛管理
- 药物使用障碍 药物使用障碍
背景情况:
- 阿片类药物依赖是一个日益严重的公共卫生问题.
- 了解接受手术性堕胎的阿片类药物依赖个体的独特需求对于公平的护理至关重要.
- 以前的研究还没有完全描述这种人群的疼痛经历和疼痛管理.
研究的目的:
- 确定接受手术性堕胎的阿片类药物依赖个体的患病率和特征.
- 为了比较阿片类药物依赖患者的过程性疼痛经验与非依赖患者的过程性疼痛经验.
- 评估静脉注射中度镇静剂对阿片类药物依赖患者疼痛控制的有效性.
主要方法:
- 一项横截面研究是在一个大规模的门诊堕胎实践中进行的.
- 一项匿名调查评估了人口统计和医疗信息,使用快速阿片类药物依赖屏幕 (RODS) 评估阿片类药物依赖,程序性疼痛以及对疼痛控制的满意度.
- 1525名参与者被纳入最终分析.
主要成果:
- 5.9%的参与者对阿片类药物依赖的查结果呈阳性.
- 吸食阿片类药物依赖的患者年龄较大,更有可能使用其他物质,患有慢性疼痛,残疾,焦虑,抑郁症,并且以前曾经堕胎过.
- 与非依赖患者相比,阿片类药物依赖患者报告的平均疼痛得分显著更高 (35比22.5),但在静脉注射中度镇静剂时经历了类似的疼痛减轻.
结论:
- 经过手术性堕胎的阿片类药物依赖个体具有不同的人口和生殖特征.
- 尽管报告的疼痛量较高,但静脉注射中度镇静剂对这种人群的疼痛管理是有效的.
- 目前的研究结果支持对阿片类药物依赖的患者进行静脉注射中度镇静,以增强其堕胎经验,并且不应受到限制.
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