手术前使用阿片类药物及其与术后并发症的关联
Jack D Sudduth1, Jessica L Marquez1, Catherine H Bautista1
1Department of Surgery, Division of Plastic Surgery, The University of Utah, Salt Lake City, UT, USA.
Journal of substance use
|June 27, 2025
概括
手术前使用阿片类药物增加了术后并发症和再入院的风险. 这一发现强调了在手术前需要仔细考虑阿片类药物处方习惯的必要性.
科学领域:
- 疼痛管理 疼痛管理
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 阿片类药物的使用带来了重大风险,促使人们寻找疼痛管理的替代方案.
- 手术前使用阿片类药物与不良患者和临床结果有关.
- 了解手术前阿片类药物使用的影响对于改善手术护理至关重要.
研究的目的:
- 评估术前阿片类药物使用与术后结果之间的关联.
- 分析这种跨不同外科的关系.
- 利用全州人口数据库来获得全面的见解.
主要方法:
- 确定了2013-2016年间接受手术的成年患者队列.
- 使用了来自犹他州所有付款人索赔数据库和犹他州人口数据库的数据.
- 手术前的阿片类药物处方 (前一年内) 是关键的独立变量,术后并发症和住院治疗是主要结果.
主要成果:
- 手术前使用阿片类药物与1.28增加任何并发症的几率有关.
- 抑郁症 (OR 1.17) 和滥用药物 (OR 1.41) 也与更高的并发症风险相关.
- 在手术前阿片类药物组 (19.43%) 和未使用阿片类药物组 (12.44%) 的患者中,再入院率显著更高.
结论:
- 手术前使用阿片类药物是不良术后结果的重要风险因素.
- 这些发现可以为临床实践提供信息,并指导术后处方决策.
- 建议加强患者与医生的关于阿片类药物使用的沟通.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
28
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
28
Cardiomyopathy VII: Pre and Post Operative Nursing Management
30
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
30
Opioid Analgesics: Morphine and Other Natural Cogeners
381
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
381
Opioid Analgesics: Synthetic and Semisynthetic Opioids
446
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
446
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
180
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
180
Analgesia and Pain Management
817
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
817


