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在接受ACDF和腰椎融合的术后大麻使用者中,门诊多模式止痛药的使用模式

Rajkishen Narayanan¹, Michael Carter¹, Gregory Toci¹

¹Department of Orthopaedic Surgery, Rothman Orthopaedic Institute Thomas, Jefferson University Hospital.

Clinical spine surgery

|September 24, 2025

概括

在脊髓融合患者中,术后使用大麻与腰部病例中更高的手术前使用阿片类药物和宫病例中增加的duloxetine使用有关. 它没有影响其他止痛药的使用.

科学领域:

脊柱手术的结果脊柱手术的结果
疼痛管理策略疼痛管理策略
大麻研究大麻研究

背景情况:

大麻在疼痛管理中的作用受到争论,随着社会越来越多的接受,促使人们研究其治疗潜力与传统止痛药一起.
关于大麻用于治疗疼痛的研究有限,特别是关于它与处方止痛药的相互作用.

研究的目的:

调查手术后止痛药的处方模式在前椎切除和融合 (ACDF) 和腰部融合后使用大麻的患者中.
为了比较术后大麻使用者和脊柱融合手术后非使用者的药物使用情况.

主要方法:

对接受ACDF或腰部融合的成年患者进行了回顾性队列研究.
根据人口统计和融合水平,根据大麻使用者和非使用者的1:1倾向得分匹配.
通过处方药监测计划 (PDMP) 和其他止痛药 (抗抑郁药, gabapentinoids,肌肉松剂,二) 通过图表审查和PDMP分析阿片类药物使用情况.

主要成果:

在126名患者中,63名 (50%) 在手术后使用大麻.
腰部融合大麻使用者在手术前使用阿片类药物的比例较高 (P=0.048).
在ACDF或腰部融合队列中,大麻使用者和非使用者之间的术后阿片类药物消费没有显著差异.
ACDF大麻使用者显示,他们更高地利用了血清素 - - 诺阿皮内林反吸收抑制剂 (SNRIs),特别是杜洛西丁 (P=0.024).
在使用三环抗抑郁药, gabapentinoids,肌肉松剂或二zepines方面没有观察到显著差异.

结论:

手术后使用大麻与腰部融合患者手术前使用阿片类药物有关.
ACDF大麻使用者表现出杜洛西丁 (一种SNRI) 的使用量增加.
手术后使用大麻与使用 gabapentinoids,肌肉松剂或二zepines 没有相关性.

关键词:

大麻大麻大麻大麻大麻大麻大麻大麻宫融合是因为宫融合.腰部融合腰部融合腰部融合大麻大麻大麻大麻是什么意思多模式止痛药多模式止痛药在阿片类药物阿片类药物.

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