皮下阿片类药物:皮肤下刺激还是新的护理标准?
Alexis Beachy1, Lynn Aung1, Natalie Malone1
1Department of Palliative Medicine (A.B., L.A., N.M., T.P., K.B.), OhioHealth Riverside Methodist Hospital, Columbus, Ohio.
Journal of pain and symptom management
|September 10, 2025
概括
一个修订后的阿片类药物管理实践标准使静脉内阿片类药物使用减少了33%,并改善了疼痛评分. 这项质量改进倡议优先考虑了口服和皮下治疗途径,以有效治疗疼痛.
科学领域:
- 疼痛管理 疼痛管理
- 提高质量 提高质量
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类药物对于住院成人疼痛管理至关重要,口服 (PO) 和静脉注射 (IV) 途径是最常见的.
- 尽管有证据支持其安全性和有效性,但阿片类药物注射的皮下 (SUB-Q) 途径尚未得到充分利用.
- 目前的做法往往有利于IV而不是SUB-Q,这为优化提供了机会.
研究的目的:
- 实施和评估对住院成年人阿片类药物管理的修订后的实践标准 (SOP).
- 在可行的情况下推广口服 (PO) 途径,并将皮下 (SUB-Q) 途径作为首选的亲肠道选择.
- 为了保持在临床上适当的情况IV阿片类药物可用性.
主要方法:
- 在24个床位的成人通用医疗病房进行质量改进试点研究.
- 跨学科教育在实施修订后的SOP之前.
- 结果包括IV和SUB-Q阿片类药物管理,阿片类药物的总消耗 (口服吗啡等价物-OME) 和患者报告的疼痛分数 (0-10级) 每个患者日 (PPD).
主要成果:
- 静脉注射 (IV) 类阿片类药物在实施后减少了33%.
- 整体阿片类药物消费 (OME) 显示了适度的减少.
- 在第一天和第五天观察到患者报告的平均疼痛得分的统计学显著减少.
结论:
- 修订后的阿片类药物SOP成功减少了IV阿片类药物的使用.
- 在整个研究期间都保持了有效的疼痛控制.
- 这些发现支持采用修订后的阿片类药物管理方案,以优化亲肠道和口腔途径.
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