评估临床医生对阿片类药物使用障碍患者急性疼痛管理的做法和态度
Megan Muller1, Abid Khan2, Nikita Thomas3
1Department of Medicine, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Substance use & addiction journal
|July 27, 2025
概括
临床医生在患有阿片类药物使用障碍 (OUD) 患者的急性疼痛管理中扎,原因是耐受性和耻辱感. 虽然有些人调整阿片类药物剂量,但许多人缺乏舒适性,强调需要更好的教育和OUD疼痛治疗指南.
科学领域:
- 医学研究 医学研究
- 临床实践中的临床实践
- 疼痛管理 疼痛管理
背景情况:
- 患有阿片类药物使用障碍 (OUD) 的患者在急性疼痛管理方面遇到挑战.
- 阿片类药物耐受性,戒断和临床因素,如耻辱和知识缺陷,使护理复杂化.
- 目前对OUD患者治疗急性疼痛的指导方针尚不清楚.
研究的目的:
- 探索临床医生的实践模式和态度.
- 专注于OUD患者的急诊室和住院急性疼痛管理.
主要方法:
- 调查分发给急诊医学,内科和创伤外科临床医生 (n=423,24.3%的应答率).
- 调查包括临床细节,知识和态度问题.
- 用描述统计和顺序逻辑回归进行分析 (n=103).
主要成果:
- 17.5%的临床医生表示OUD诊断不会改变疼痛管理.
- 超过一半 (52.4%) 将在OUD患者中使用更高剂量的IV阿片类药物.
- 只有51.5%的人觉得在治疗OUD患者的急性疼痛时感到舒适; 64.1%的人觉得OUD症状没有得到严重的治疗.
结论:
- 大多数临床医生了解OUD疼痛管理的药理原理 (例如,更高的耐受性需要更多的阿片类药物).
- 很大一部分人不会改变治疗方法,或者会拒绝使用阿片类药物.
- 加强教育,临床决策支持和明确的指导方针是必要的,以改善OUD患者的护理和舒适度.
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