加巴丁:关于其作为结肠直肠提供者的术后止痛药的使用的观点
Manjia Zhao1, Joao Filipe G Monteiro2, Matthew Vrees3
1Brown School of Public Health, Providence Rhode Island.
Rhode Island medical journal (2013)
|September 26, 2025
概括
结肠直肠外科医生通常为术后疼痛处方 gabapentin (Gb),相信它可以减少阿片类药物的使用,并提供止痛. 然而,支持这些益处的证据有限,突出了对其临床应用的理解上的差距.
科学领域:
- 手术疼痛管理手术疼痛管理
- 药理学 药理学是指药理学的学科.
- 基于证据的医学 基于证据的医学
背景情况:
- gabapentin (Gb) 经常用于术后疼痛管理,主要是为了减少阿片类药物消耗.
- 在这种情况下,支持 gabapentin 疗效的证据基础并不强大.
- 缺乏详细说明外科医生使用 gabapentin 的理由和方法的文献.
研究的目的:
- 调查结直肠外科医生在术后疼痛管理中对 gabapentin 的处方模式和感知好处.
- 了解外科医生为什么以及如何在临床实践中使用 gabapentin 的原因.
- 评估人们对与 gabapentin 使用相关的潜在益处和风险的认识.
主要方法:
- 在2024年8月至10月期间,一项调查通过电子邮件发送给新英格兰结肠和直肠外科医生协会 (NESCRS) 的85名成员.
- 总共收到32个回复,其中28个被纳入最终分析.
- 该调查收集了有关人口统计,常规处方止痛药和 gabapentin 感知影响的数据.
主要成果:
- 57%的受访者处方了 gabapentin,阿片类药物 (96%),乙氨基 (93%),NSAIDs (68%) 也常被使用.
- 提供者认为 gabapentin 减少了阿片类药物的使用 (75%),提供了止痛 (54%),并减少了阴茎 (39%),停留时间 (21%),以及妄想 (4%).
- 经验丰富的提供者更有可能报告说, gabapentin 的益处超过了其风险 (69%),并且他们对管理不良影响 (38%) 充满信心.
结论:
- 结肠直肠提供者承认 gabapentin 作为术后止痛药的潜在好处,包括阿片类药物节约作用.
- 尽管证据有限,但加巴丁被广泛使用,这表明其被认为具有临床效用.
- 需要进一步的研究来建立一个更强有力的证据基础来证明 gabapentin 在术后疼痛管理中的作用,并解决潜在的风险.
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