降低阿片类药物剂量与腰部中间分支之间的干预
David H Rustom1, Alexander A Restum2, Kevin F Henry3
1Pain Management, Wayne State University Detroit Medical Center, Detroit, USA.
Cureus
|June 17, 2025
概括
腰部面关节病 (LFA) 疼痛可以通过腰部中间分支块 (LMBBs) 和射频切除 (RFA) 来减少. 这些程序在LFA患者中显著减少了处方阿片类药物的使用.
科学领域:
- 疼痛医学 医学 疼痛医学
- 干预性疼痛管理 干预性疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰部侧关节病 (LFA) 是一种退行性疾病,导致慢性腰部疼痛,特别是在40岁以上的人群中.
- 类似于骨关节炎的变化,包括骨过度生长和突囊,是LFA的特征.
- 在腰椎中,L4/L5和L5/sacral接口最常受到影响.
研究的目的:
- 调查腰部中间分支阻塞 (LMBBs) 和射频剥离 (RFAs) 以及处方阿片类药物使用的减少之间的关联.
- 评估LMBBs和RFAs在管理与LFA相关的疼痛方面的有效性.
主要方法:
- 进行了一项追溯队列研究,对526名已记录LFA患者进行了追溯队列研究.
- 患者接受了LMBB,RFA或两种手术的组合.
- 在干预之前和之后,使用对联t-test比较了与吗啡相当的阿片类药物处方.
主要成果:
- 在LMBB或组合LMBB和RFA程序后,观察到处方阿片类药物使用的统计显著减少.
- 接受LMBB治疗的患者显示,阿片类药物相当剂量平均减少了4.06毫克.
- 接受LMBB和RFA治疗的患者经历了6.10毫克的更大平均减少.
结论:
- 在LFA患者中,LMBB和RFA程序有效地减少了处方阿片类药物的使用.
- LMBB和RFA的组合可能会有助于减少阿片类药物消费.
- 这些干预措施显示出降低疼痛和LFA相关的医疗负担的潜力.
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