美国外科医生在美国的手术后疼痛管理与低收入和中等收入国家
Matthew S Linz1, Fatemeh P Parvin-Nejad2, Nivetha Srinivasan3
1Rutgers New Jersey Medical School, Newark, New Jersey USA.
Journal of the American College of Surgeons
|July 30, 2025
概括
美国外科医生在手术后处方的阿片类药物的数量明显多,与他们在国外进行手术时相比. 这凸显了在美国减少阿片类药物过度处方和促进非阿片类药物疼痛管理的需要.
科学领域:
- 全球手术全球手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 尽管正在进行的阿片类药物流行病,但阿片类药物的过度处方在美国仍然存在.
- 美国外科医生在国际短期外科旅行期间的处方模式尚不清楚.
- 这项研究比较了美国外科医生在美国进行手术后的阿片类药物处方,与去低收入和中等收入国家 (LMICs) 进行手术时的处方.
研究的目的:
- 为了比较美国和LMIC患者之间的术后阿片类药物处方实践.
- 为了识别疼痛药物管理中的差异.
- 为减少在外科护理中过度依赖阿片类药物的战略提供信息.
主要方法:
- 对接受开放 inguinal 修复 (2013-2019) 的成年患者的回顾性图表审查.
- 在手术后24小时内和出院时的阿片类和非阿片类止痛药处方的比较.
- 对人口和外科手术期间的特征进行分析.
主要成果:
- 76.0%的美国患者在术后接受了阿片类药物,而LMIC患者的这一比例为19.4% (p<0.00001).
- 美国患者的中位数为8.7毫克口服吗啡等价物 (OME),而LMIC患者的中位数为0毫克OME (p<0.0001).
- 在美国和LMICs之间观察到阿片类药物处方的显著差异.
结论:
- 美国外科医生在术后处方大量的阿片类药物比在LMIC中工作时要高得多.
- 在美国手术环境中,有很大的潜力减少阿片类药物处方.
- 应鼓励增加非阿片类止痛药的使用,以打击阿片类药物过度处方.
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