在门诊全膝关节整形手术中服用阿片类药物的性别差异
Jiwoo Park1, Graham Sabo1, Mayuri Jain2
1Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
The Journal of arthroplasty
|August 23, 2025
概括
在门诊全膝关节整形术 (TKA) 后,男性接受了较高的阿片类药物剂量,但在手术后继续使用阿片类药物的可能性较低. 在TKA后,女性可能面临更高的持续阿片类药物使用风险.
科学领域:
- 整形医学
- 治疗疼痛
- 药理学
背景情况:
- 在全膝关节整形术 (TKA) 后处方阿片类药物的性别差异已知,但在门诊环境和老年人中不太了解.
- 这项研究调查了外科TKA的外科阿片类药物处方的性别差异.
研究的目的:
- 在门诊全膝关节整形手术期间检查阿片类药物处方模式的性别差异.
- 为了比较外科治疗期间的阿片类药物处方,处方的阿片类药物剂量 (MME),以及接受门诊TKA的男性和女性之间的亚急性和持续性阿片类药物使用率.
主要方法:
- 使用国家和Medicare补充数据库进行回顾性队列研究 (2018-2021年).
- 包括18至64岁 (商业) 和65岁以上 (医疗保险) 的初级门诊TKA患者.
- 多变量回归分析了性别和阿片类药物结果之间的关联,并对共变量进行了调整.
主要成果:
- 在商业队列中,男性的MME较高,亚急性/持续性阿片类药物使用率较低.
- 在医疗保险队列中,男性的处方使用率更高,MME的使用率更高,亚急性阿片类药物使用率更低.
- 在商业队列中没有发现填写处方的性别差异.
结论:
- 接受门诊TKA的男性接受了更高的术后阿片类药物剂量,但术后阿片类药物持续使用的可能性降低.
- 在门诊TKA后,女性可能面临更高的持续阿片类药物使用风险,因此需要进一步调查.
- 了解这些基于性别的差异背后的机制对于优化疼痛管理和阿片类药物管理至关重要.
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