脊椎手术后的阿片类药物使用障碍和报告的疼痛:纵向队列研究中的认知评估过程中的风险组模式
Carolyn E Schwartz1,2, Katrina Borowiec1,3, Bruce D Rapkin4
1DeltaQuest Foundation Inc, Concord, MA, United States.
North American Spine Society journal
|April 21, 2025
概括
脊椎外科手术患有阿片类药物使用障碍 (OUD) 高风险的患者在手术前专注于问题解决目标时,经历的疼痛较小. 低风险患者在这种方法中报告了更多的疼痛,这表明针对OUD风险量身定制的干预措施.
科学领域:
- 疼痛管理 疼痛管理
- 心理学 心理学 心理学
- 脊柱外科手术 脊柱外科手术
背景情况:
- 脊柱疾病会导致慢性疼痛,随着长期使用阿片类药物,增加阿片类药物使用障碍 (OUD) 的风险.
- 认知评估过程可能会缓解OUD风险和疼痛结果之间的关系.
- 了解这些调节者对于开发有效的疼痛管理策略和预防OUD至关重要.
研究的目的:
- 调查认知评估过程作为OUD风险的调节者在接受脊椎手术的患者中.
- 检查手术前和手术后的认知评估如何影响基于OUD风险的疼痛感知.
- 确定早期干预的潜在目标,以减轻OUD风险和改善疼痛管理.
主要方法:
- 这是一项对342名接受脊柱手术的成年人进行的纵向队列研究.
- 使用数值评分尺度评估疼痛;认知评估过程通过生活质量评估概况v2-简单表格进行测量.
- 根据医疗记录验证的自我报告的阿片类药物使用情况分类的OUD风险组;回归模型分析了3个月后的疼痛,考虑了评估和OUD风险相互作用.
主要成果:
- 手术前认知评估 手术后3个月缓解疼痛,取决于OUD风险.
- 支持更多解决问题目标的高OUD风险患者报告了较低的疼痛.
- 支持更多解决问题目标的低OUD风险患者报告了更高的疼痛;手术后评估没有缓解OUD风险与疼痛的关系.
结论:
- 手术前的认知评估显著影响脊柱手术患者的疼痛感知,基于他们的OUD风险.
- 对于高OUD风险个体,解决问题的重点与疼痛减少有关,而与低OUD风险个体的疼痛增加有关.
- 这些发现表明,根据OUD风险量身定制的术前认知和正念干预措施可能对疼痛管理有益.
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