儿科尾切除术后的阿片类药物处方:一个NSQIP-P研究
Amna Minhas1, Humza Thobani2, Arsalan Javid3
1Loma Linda University Health, Department of General Surgery, Division of Pediatric Surgery, Loma Linda, CA, USA.
Journal of pediatric surgery
|July 19, 2025
概括
儿科尾切除术后的阿片类药物处方仍然存在,尽管比例下降,但与患者人口统计和成像选择相关的变化. 出院的阿片类药物与更多的急诊室访问有关,但没有再入院.
科学领域:
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 在小儿尾切除术后的阿片类药物处方模式尚不清楚.
- 离院阿片类药物使用的变化可能会影响患者的治疗结果.
研究的目的:
- 评估儿童尾切除患者阿片类药物处方的国家趋势.
- 分析出院的阿片类药物处方与随后的急诊室 (ED) 访问和再接收之间的关联.
主要方法:
- 国家外科质量改善计划 - 儿科 (NSQIP-P) 数据库 (2023) 的回顾性分析.
- 包括为简单或复杂的尾炎进行尾切除的儿科患者 (<18岁).
- 多变量后勤回归以确定阿片类药物处方的预测因素及其与ED访问和再录取的关联.
主要成果:
- 在22148名儿科尾切除术患者中,5.2%的患者在出院时接受了阿片类药物.
- 处方阿片类药物的预测因素包括年龄较大,男性性别,黑人/非洲裔美国人种族,没有超声波的CT和更短的住院时间.
- 出院的阿片类药物与急救室访问的几率增加有关 (aOR 1.28) 但没有计划外的再入院 (aOR 1.13).
结论:
- 在小儿尾切除术后,阿片类药物处方的显著变化仍然存在.
- 患者的人口统计和成像方式 (CT与超声波) 影响处方模式.
- 优化疼痛管理和减少不必要的阿片类药物暴露至关重要.
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