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在结肠和直肠手术后长期使用阿片类药物
Kerri A McKie1, Robert A Malizia1, Adam C Fields1
1Division of Colorectal Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
The Journal of surgical research
|May 23, 2025
概括
标准化的非毒品手术后增强恢复 (ERAS) 途径减少了在接受结肠直肠手术的先前未使用阿片类药物的患者中长期使用阿片类药物. 这项研究显示,从2017年到2020年,持续性阿片类药物使用量逐步减少.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 美国面临着严重的阿片类药物流行.
- 手术后增强恢复 (ERAS) 途径旨在尽量减少外科手术期间的阿片类药物消费.
- 接受结直肠外科手术的未使用过阿片类药物的患者是评估长期阿片类药物使用的重点.
研究的目的:
- 为了确定是否标准化,非毒品ERAS协议减少长期阿片类药物使用在结直肠外科手术后的阿片类药物未使用的患者.
- 分析术后持续使用阿片类药物的趋势.
主要方法:
- 从2017年到2020年,对1363名先前未使用过阿片类药物的患者进行了回顾性队列研究.
- 数据来源于美国外科医生学院国家外科质量改善计划和史诗系统.
- 在五个机构中实施了标准化的ERAS协议.
主要成果:
- 从2017年到2020年,长期使用阿片类药物的逐步减少被观察到.
- 在6个月和12个月的持续阿片类药物使用在研究期间显著下降 (P <0.01).
- 例如,在2017-2018年,16%和11%的患者在6个月和12个月使用了阿片类药物,而在2019-2020年,这一比例为11%和4%.
结论:
- 在ERAS途径中标准化阿片类药物节约策略有效地减少了长期阿片类药物使用.
- 一小部分以前从未服用过阿片类药物的患者在手术后的一年内仍可能持续使用阿片类药物.
- 这些发现支持使用非毒品ERAS协议来打击手术环境中的阿片类药物危机.
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