在初级保健疼痛管理中,阿片类药物管理和胃肠道 (GI) 节省替代品
Anusha Khan1, Aftab Ahmad2, Syed Sharjeel Ibrar3
1Medical Ethics, Northwell Health, Long Island Jewish Medical Center, New York, USA.
Cureus
|July 28, 2025
概括
初级保健提供者可以通过采用阿片类药物管理和利用消化道节约替代品来改善慢性疼痛管理. 这种方法平衡了有效的疼痛缓解与减少成和胃肠道毒性的风险.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 慢性疼痛影响全球30%的成年人,造成严重的残疾挑战.
- 在美国,初级保健提供者 (PCP) 是慢性疼痛管理的核心.
- 过度使用阿片类药物导致国家危机,需要更安全的处方策略.
研究的目的:
- 为PCP提供阿片类药物管理原则的概述.
- 为慢性疼痛管理提供基于证据的,节省胃肠道的替代方案.
- 应对实施安全有效的疼痛管理策略的挑战.
主要方法:
- 根据SANRA的指导方针进行叙事审查.
- 在PubMed,MEDLINE,EMBASE和科克兰图书馆 (2010-2025) 的文献搜索.
- 指南,评论和临床研究的专题组织.
主要成果:
- 阿片类药物管理包括风险评估,知情同意,保守的启动,监测和放弃处方.
- 消化道风险减轻包括谨慎使用NSAID,共同处方PPI和COX-2选择性药物.
- 有效的替代品包括乙氨基,抗抑郁药,抗药,局部药物和非药物疗法.
结论:
- 实施安全的慢性疼痛管理面临时间限制和获得治疗等障碍.
- 提供者教育,跨学科的团队合作和EHR集成可以克服这些挑战.
- 以患者为中心的方法对于可持续的疼痛缓解至关重要,同时尽量减少伤害.
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