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在全膝关节关节整形术后,医院内暴露和处方的阿片类药物
Clifton Daigle1, Robert Branstetter1, Leland Van Deventer1
1Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana.
在全膝关节整形术 (TKA) 患者中尽量减少在医院中的阿片类药物暴露,可能会减少术后阿片类药物处方. 较低的手术前疼痛评分与TKA手术后阿片类药物使用的减少有关.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类药物通常用于全膝关节整形术 (TKA),但有不良影响.
- 这项研究调查了在未使用过阿片类药物的TKA患者中医院内阿片类药物暴露和术后阿片类药物处方之间的联系.
研究的目的:
- 确定医院内阿片类药物暴露是否会影响阿片类药物未使用的TKA患者的术后阿片类药物处方.
- 在TKA中确定与术后阿片类药物处方相关的因素.
主要方法:
- 对接受单方面初级TKA的阿片类药物未使用患者的回顾性研究 (2020年5月-2023年11月).
- 基于医院内阿片类药物暴露的TKA后三个月内填写的阿片类药物处方的分析.
- 患者遵循了一种一致的多模式疼痛协议.
主要成果:
- 29.8%的患者填写了术后阿片类药物处方 (OP-T组).
- 较低的手术前疼痛评分与填补阿片类药物处方的可能性降低有关 (调整后的几率比率 = 0.675,P = 0.002).
- 在OP-T组 (45.2%对27.3%) 观察到,在麻醉后护理单位内,静脉注射阿片类药物的使用率较高.
结论:
- 在TKA期间尽量减少阿片类药物暴露,无论是在手术前还是在医院,对于有效的疼痛管理至关重要.
- 无阿片类药物多式止痛疗法可以优化疼痛控制,并减轻TKA患者的阿片类药物相关风险.
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