阿片类药物处方:在大型腹腔外科手术后真的需要吗? 一个单一的集中前性研究
Kathryn E Ottaviano1, Badar M Mian2, Ashar Ata1
1Department of Surgery, Albany Medical Center, Albany, New York, United States.
概括
一个新的协议安全地消除了重大手术的常规阿片类药物处方. 这种方法可以减少退院后的阿片类药物使用,而不会影响患者的康复或再入院率.
科学领域:
- 手术疼痛管理手术疼痛管理
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 吸食阿片类药物是手术康复的一个重要问题.
- 实施了一项协议,以消除常规阿片类药物处方,用于需要住院护理的大型结肠直肠和整体手术.
研究的目的:
- 评估非常规阿片类药物治疗方案在重大腹部和骨盆外科手术中的有效性和安全性.
- 确定本协议对阿片类药物处方率和患者结局的影响.
主要方法:
- 前性队列研究,比较干预前 (控制) 和干预后 (阿片类药物节约) 组.
- 干预组接受了关于非阿片类止痛药和避免阿片类药物的咨询.
- 分析了州级处方数据和30天的结果.
主要成果:
- 退院后30天内服用阿片类药物的比例显著下降,从对照组的46%降至干预组的17% (P <.001).
- 退院时中位数的阿片类药物处方在干预组为0,对照组为10毫克吗啡等价物 (P <.001).
- 两组之间30天再接收率没有显著差异 (P = .475).
结论:
- 接受重大腹腔和骨盆外科手术的先前未服用阿片类药物的患者可以安全地省略常规阿片类药物处方.
- 这种阿片类药物节约方法可以在手术后增强恢复计划中实施,而不会影响患者的恢复.
- 这些发现支持在手术环境中转向非阿片类药物疼痛管理策略.
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