儿科腺切除术后的疼痛管理:阿片类药物是否影响医疗保健利用率?
1University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, 12328 Vanderbilt University Medical Center, Nashville, TN, USA.
American journal of otolaryngology
|May 16, 2025
概括
在儿科腺切除术 (AT) 后限制阿片类药物处方并没有显著影响医疗保健利用率. 然而,在非阿片类药物治疗方案的幼儿打了更多的电话,种族影响了疼痛和脱水的呼叫率.
科学领域:
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
- 医疗保健利用情况 医疗保健利用情况
背景情况:
- 腺切除术 (AT) 是一个常见的儿科门诊手术.
- 建议使用多模式疼痛管理来减轻阿片类药物风险.
- 这项研究调查了基于术后药物治疗方案的医疗保健利用情况.
研究的目的:
- 根据他们的术后药物治疗方案,评估儿科AT患者的医疗保健利用差异.
- 分析阿片类与非阿片类疼痛管理对呼叫和急诊室 (ED) 访问的影响.
- 探索与医疗保健利用有关的药物,年龄组和种族之间的潜在相关性.
主要方法:
- 对接受AT的699名儿科患者 (3-18岁) 的回顾性分析.
- 患者分为幼儿 (3-4岁),儿童 (5-12岁) 和青少年 (≥13岁) 的阶层.
- 收集了总电话,疼痛/脱水 (P/D) 的电话和ED访问的数据;分析了药物治疗方案.
主要成果:
- 在5岁及以上的患者中,阿片类药物处方和电话或ED访问P / D之间没有显著的相关性.
- 接受非阿片类药物治疗的幼儿 (3-4岁) 发生任何电话的可能性更高 (p=0.049).
- 白人患者的电话呼叫率 (p=0.0183) 和P/D相关呼叫率 (p<0.001) 较高;急救诊所没有种族差异.
结论:
- 减少儿科AT患者的阿片类药物处方似乎不会对整体医疗保健利用产生负面影响.
- 小孩子的阿片类药物使用与更少的电话联系在一起,尽管不是专门用于P / D.
- 需要进一步的前性研究来记录疼痛评分和药物管理,以实现最佳的疼痛控制优化.
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