术后使用 gabapentinoid 减少长期阿片类药物依赖后长段腰部仪器:回顾性倾向匹配分析
Janesh Karnati1,2, Andrew Wu1,2, Xu Tao1,2
1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Spine
|August 22, 2025
概括
腰部融合手术后早期使用 gabapentinoid 可能会减少长期使用阿片类药物的需要. 这项研究发现 gabapentinoids 降低了 3-6 段融合的强阿片类药物处方,但不是更大的.
科学领域:
- 神经外科
- 治疗疼痛
- 药理学
背景情况:
- 甲类药物用于神经性疼痛,可能会增强阿片类药物的作用.
- 它们在经过大规模脊椎手术后减少长期阿片类药物的作用尚不清楚.
研究的目的:
- 调查手术后的 gabapentinoid 处方是否会影响长期使用阿片类药物后长段后腰部仪器.
- 根据脊柱融合的程度 (3-6对7-12段) 来分析这种关联.
主要方法:
- 使用TriNetX研究网络对接受后腰部仪器 (3-12段) 的患者进行回顾性队列分析.
- 患者根据仪器的程度和他们是否在术后30天内服用 gabapentinoids (gabapentin/ pregabalin) 进行了分层.
- 倾向性得分匹配 (1:1) 用于控制混因子,在手术后的24个月内评估阿片类药物处方.
主要成果:
- 在3-6段融合组中,早期使用 gabapentinoid 与所有随访点的非可代因和强阿片类药物处方的几率显著降低.
- 在3至6个月期间,接受 gabapentinoids 的患者出现较低的阿片类药物处方几率.
- 在7-12段融合组中没有发现阿片类药物处方的显著差异.
结论:
- 在3-6段腰部融合后,早期术后的 gabapentinoid 处方与慢性使用非可代因类和强类阿片类药物减少有关.
- 甲类药物可以作为多式止痛药的重要成分,有可能减少对强效阿片类药物的依赖,并减轻脊柱手术患者的长期依赖风险.
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