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在初级全膝关节整形术后,与较高的住院阿片类药物消费相关的因素:一项追溯的三级中心分析

Moe Takenoshita¹, Andreas Fontalis², Anthony B Lisacek-Kiosoglous¹

¹Department of Trauma and Orthopaedic Surgery, University College Hospital, London, United Kingdom.

|November 27, 2025

概括

在全膝关节整形术患者的术后阿片类药物消费量在第三天迅速下降. 早期高阿片类药物使用 (24-48小时) 预测整体住院患者的消费,年轻的年龄,更高的BMI和全身麻醉是危险因素.

科学领域:

整形外科手术整形外科手术
疼痛管理疼痛管理
药理学药理学是指药理学的学科.

背景情况:

在全膝关节整形术 (TKA) 后的术后疼痛管理通常涉及阿片类止痛药.
描述住院阿片类药物消费 (OC) 和识别相关风险因素对于优化疼痛控制和最大限度地减少阿片类药物依赖至关重要.

研究的目的:

在全膝关节整形术 (TKA) 患者的住院术后阿片类药物消费 (OC) 的特征.
确定与TKA患者高OC相关的危险因素.

主要方法:

在2019年5月至2023年7月期间进行的1,550个TKA的回顾性分析.
收集的数据包括麻醉类型,PACU入院,手术细节和OC的口服吗啡等价物 (MME).
使用斯皮尔曼相关性和多变量逻辑回归来评估OC模式并确定高阿片类药物使用的预测因素.

主要成果:

总住院患者的中位数OC为96.0毫克MME,其中86.5%在术后的前72小时内消耗.
从第1天到第3天,阿片类药物的使用减少了71.4%.
在术后24-48小时内高OC与住院患者的总OC有很强的相关性 (rs=0.717,p<0.001).
高度阿片类药物使用的预测因素包括年龄较小,BMI较高,全身麻醉,PACU入院以及ASA类3或4.

结论:

在TKA患者的住院阿片类药物使用量在术后的第三天显著下降.
术后早期的阿片类药物消费 (24-48小时) 是整体住院患者阿片类药物需求的强有力的指标.
年龄较小,BMI较高和全身麻醉是高阿片类药物消费的重要风险因素,为有针对性的疼痛管理策略提供了信息.

关键词:

这是一种阿片类药物.整形外科手术整形外科手术疼痛管理疼痛管理这就是TKA TKA TKA.整体膝关节关节整形手术

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