手术前的阿片类药物处方增加了腰部减压手术后慢性阿片类药物使用的风险
Nam V Huynh1, Darcy Fay1, Aaron J Buckland1,2,3
1Spine and Scoliosis Research Associates Australia, Windsor, VIC, Australia.
Global spine journal
|November 10, 2025
概括
手术前使用阿片类药物显著增加了需要和持续时间的阿片类药物使用后腰部减压手术. 尽量减少手术前阿片类药物处方对于减少这些患者长期阿片类药物依赖至关重要.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 健康 结果 研究 研究 结果
背景情况:
- 手术前的阿片类药物处方在脊柱外科手术中越来越令人担忧.
- 了解其对手术后阿片类药物使用及其患者结果的影响至关重要.
研究的目的:
- 分析手术前阿片类药物处方对腰部减压后慢性阿片类药物使用的影响.
- 评估对患者报告结果 (PROM) 的影响.
主要方法:
- 对254名接受1~2级腰部减压的患者进行了回顾性队列研究.
- 对先前未使用阿片类药物和对阿片类药物敏感的患者进行比较.
- 回归分析以确定术后阿片类药物使用的预测因素.
主要成果:
- 对阿片类药物敏感的患者在6个月后需要3倍的术后MME (吗啡毫克相当量).
- 手术前使用阿片类药物超过3个月显著增加了手术后使用阿片类药物的风险 (OR 13.4-27.4).
- 尽管阿片类药物使用较高,但手术后PROM在各组之间是相似的.
结论:
- 术前阿片类药物处方是术后阿片类药物需求增加和慢性使用的强有力的预测因素.
- 尽量减少手术前阿片类药物暴露可能会减少腰部减压后的长期阿片类药物使用.
- 建议及时推非阿片类药物疼痛管理策略.
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