患者大麻使用对外科手术期间阿片类药物需求的影响
Joseph Pitts1, Madeline Henry2, Huaqing Zhao3
1Lewis Katz School of Medicine, Philadelphia, Pennsylvania. ORCID: https://orcid.org/0009-0002-6504-1623.
Journal of opioid management
|October 22, 2025
概括
慢性大麻使用可能会减少手术患者的手术内阿片类药物需求. 这项研究发现,大麻使用者在手术期间需要更少的阿片类药物,在其他麻醉剂或术后疼痛管理方面没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 药物使用研究研究 药物使用研究
背景情况:
- 长期使用大麻对手术患者的影响尚不清楚.
- 大麻的生理效应需要在医疗和外科护理中加以考虑.
- 慢性大麻消费可能会改变外科手术期间的阿片类药物需求.
研究的目的:
- 调查慢性大麻使用与手术内阿片类药物,,和麻醉后护理单位的阿片类药物需求之间的关联.
- 为了比较大麻使用者的麻醉剂和阿片类药物消费与接受手术的非使用者.
- 为了确定大麻使用是否影响患者的手术疼痛管理需求.
主要方法:
- 追溯观察性研究分析了570名患者的电子病历.
- 根据自我报告,患者被分为大麻使用者或非使用者.
- 根据年龄,性别,体重和手术程序进行了病例匹配.
主要成果:
- 大麻使用者需要的手术内阿片类药物 (27.2MME) 与非使用者 (31.3MME) 相比显著减少 (p=0.02).
- 对种族差异的统计调整证实了大麻使用者的手术内阿片类药物需求显著减少 (p=0.013).
- 没有观察到群体之间的手术期间的propofol或麻醉后护理单位阿片类药物需求的统计学上显著差异.
结论:
- 与匹配的非使用者相比,大麻使用者表现出减少了手术内阿片类药物需求.
- 麻醉管理,特别是propofol和术后阿片类药物需求,在大麻使用者和非使用者之间没有显著差异.
- 关于大麻使用的手术前查,包括频率和持续时间,可以提高对手术阿片类药物需求的理解.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
908
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
908
Opioid Analgesics: Morphine and Other Natural Cogeners
848
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
848
Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
Parenteral Anesthetics: Overview
574
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
574
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
611
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
611
Opioid Receptors: Overview
4.0K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
4.0K


