在有医疗补助的外科患者中患有阿片类药物使用障碍的风险以及与处方阿片类药物的剂量和持续时间的关联
Lisa V Doan1, Anton M Hung2, Nicholas T Williams2
1Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University Grossman School of Medicine, New York, NY, USA.
Journal of pain research
|December 11, 2025
概括
在接受手术的未使用过阿片类药物的患者中,减少阿片类药物处方时间和剂量可以降低患阿片类药物使用障碍 (OUD) 的风险. 这项研究强调了保守的处方对于术后疼痛管理的重要性,以减轻OUD的发生率.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类药物经常被处方用于术后疼痛管理.
- 在未使用过阿片类药物的外科手术患者中,发展阿片类药物使用障碍 (OUD) 的风险尚不清楚.
- 医疗补助受益人代表了OUD发展的弱势群体.
研究的目的:
- 为了调查OUD在手术后未使用过阿片类药物的患者中的发病率.
- 评估减少阿片类药物处方时间和/或剂量与OUD风险之间的关联.
- 为基于证据的治疗术后疼痛的处方指南提供信息.
主要方法:
- 分析来自25个州的医疗补助T-MSIS分析文件 (2016-2019).
- 包括之前从未服用过阿片类药物的成年患者,接受手术,并使用外科期间的阿片类药物处方.
- 使用一种非参数,双重可靠的估计器来确定关联.
主要成果:
- 包括178,133名非剖腹产和164,936名剖腹产患者.
- 2年后OUD发生率为1.47% (非剖腹产) 和1.44% (剖腹产).
- 减少处方时间20%降低了15-18%的OUD风险;减少剂量和时间20%降低了26-27%的风险. 仅仅降低剂量并没有显著降低风险.
结论:
- 降低阿片类药物处方时间和每日剂量与未使用阿片类药物的手术患者发生OUD风险降低有关.
- 剂量和持续时间的综合降低证明了最显著的风险减轻.
- 研究结果支持在手术后进行保守的阿片类药物处方实践,以预防OUD.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
878
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...
878
Opioid Analgesics: Morphine and Other Natural Cogeners
808
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...
808
Analgesia and Pain Management
1.4K
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...
1.4K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
514
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
514
Drug Dosing: Obese Patients
198
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
198
Prescription, Nonprescription and Orphan Drugs
1.1K
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
1.1K


