在接受选择性软组织手术的口服抗凝剂患者的外科阿片类药物处方
Thompson Zhuang1, Hannah H Lee2
1Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.
The Journal of hand surgery
|November 19, 2025
概括
在手术前服用口服抗凝剂的患者更有可能获得阿片类药物处方. 这项研究强调了在这个不断增长的患者群体中需要谨慎的疼痛管理策略.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 口服抗凝药在手术患者中越来越常见.
- 非类固醇抗炎药物通常是禁忌的,使疼痛管理复杂化.
- 阿片类药物处方对手术后服用抗凝血剂的患者构成风险.
研究的目的:
- 调查术前口服抗凝剂使用与术后阿片类药物处方之间的关联.
- 分析在接受选手手术的未使用阿片类药物的患者中阿片类药物处方率.
主要方法:
- 对国家行政索赔数据库的回顾性分析.
- 包括未使用过阿片类药物的成年人接受可选软组织手术.
- 倾向性得分匹配用于比较患有和没有手术前口服抗凝剂 (直接口服抗凝剂或华法林) 的患者.
主要成果:
- 术前口服抗凝剂的使用与术前阿片类药物处方的可能性更高 (DOACs的OR为1.77,华法林的OR为1.59).
- 可与乙氨基和特拉马多尔是最常被处方的阿片类药物.
- 在阿片类药物处方和术后急诊室访问之间没有发现显著的关联.
结论:
- 在手术前使用口服抗凝剂增加了手术前阿片类药物处方在选择性软组织手术中的发生率.
- 这种关联强调了针对抗凝血药患者量身定制的疼痛管理方案的重要性.
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