更高的术后 gabapentin 剂量与肩部全关节整形术后的肺部并发症有关
Julian Wier1, Cory K Mayfield1, Kevin C Liu1
1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
JSES international
|October 6, 2025
概括
在肩膀置换手术后使用 gabapentin 会增加肺部并发症的风险. 较高的 gabapentin 剂量与更大的风险相关,但阿片类药物使用在各组中仍然相似.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 加巴丁类药物越来越多地用于肩部全关节整形术 (TSA) 后的疼痛管理.
- 人们对 gabapentinoid 诱导的镇静和呼吸抑制存在担忧,特别是在阿片类药物联合使用时.
- 该研究调查了 gabapentin 对TSA后肺部并发症和阿片类药物使用的影响.
研究的目的:
- 评估术前对 gabapentin 暴露和初级 TSA 后的术后肺部并发症之间的关联.
- 为了评估不同的 gabapentin 剂量对 TSA 后阿片类药物总利用的影响.
- 为了确定加巴丁是否是肩膀手术后肺部问题的独立风险因素.
主要方法:
- 在2016-2020年使用Premier Healthcare数据库对86,137名接受初级TSA治疗的患者进行了回顾性分析.
- 根据术后第一天的 gabapentin 剂量,患者被分为四组:控制 (0 mg),低 (1-300 mg),中度 (301-900 mg) 和高 (>900 mg).
- 多变量模型评估了肺部并发症 (aOR) 的几率,并比较了各组之间的平均每日吗啡毫克相当量 (MMEs).
主要成果:
- 与对照组相比,接受 gabapentin (低剂量,中剂量,高剂量) 的患者显示肺部并发症的几率明显增加 (aOR 分别为1.15,1.17,1.45).
- 高剂量 gabapentin 组的肺部并发症几率最高 (aOR:1.45).
- 在 gabapentin 剂量组之间没有观察到平均每日 MME 摄入量的临床显著差异.
结论:
- 术后的 gabapentin 暴露独立地与 TSA 后肺部并发症的更高风险有关.
- gabapentin 的剂量似乎与这些并发症的风险增加有关.
- gabapentin 在研究人群中没有显著改变整体阿片类药物需求.
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