吸烟与阿片类药物需求与术后早期疼痛强度之间的关联:元分析
Istvan S Szilagyi1, Torsten Ullrich2,3, Christoph Klivinyi4
1Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
Pain and therapy
|December 13, 2025
概括
与非吸烟者相比,吸烟者需要明显更多的阿片类药物来治疗术后疼痛. 这一元分析强调了在疼痛控制策略中需要考虑吸烟状态的必要性.
科学领域:
- 麻醉学和疼痛管理
- 公共卫生 公共卫生
- 临床药理学 临床药理学
背景情况:
- 有效的术后疼痛管理对于患者的康复和满意度至关重要.
- 吸烟对术后疼痛和止痛药的影响尚不清楚.
- 在手术后调查吸烟者和非吸烟者之间阿片类药物需求的差异至关重要.
研究的目的:
- 为了确定吸烟者与非吸烟者在手术后24到48小时内是否有不同的术后阿片类药物需求.
- 分析吸烟状态和术后疼痛强度之间的关联.
- 通过了解吸烟的影响来告知疼痛管理策略.
主要方法:
- 对比研究的系统审查和元分析.
- 在科学网和PubMed.com进行的文献搜索.
- 标准化阿片类药物剂量为吗啡等价物;使用随机效应模型.
主要成果:
- 吸烟者在手术后24小时 (SMD 0.90) 和48小时 (SMD 0.61) 需要显著更高的阿片类药物剂量.
- 平均而言,吸烟者比非吸烟者需要33.7%的阿片类药物.
- 吸烟者在手术后24小时报告疼痛得分显著增加 (SMD0.59).
结论:
- 与非吸烟者相比,吸烟患者的术后阿片类药物需求和疼痛评分显著增加.
- 有证据表明,吸烟状态是术后疼痛管理的关键因素.
- 需要进一步的研究来探索潜在的机制,并优化吸烟者的疼痛控制.
相关概念视频
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
Opioid Analgesics: Synthetic and Semisynthetic Opioids
872
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...
872
Opioid Analgesics: Morphine and Other Natural Cogeners
796
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...
796
Opioid Receptors: Overview
3.8K
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,...
3.8K
Peripheral Artery Disease V: Postoperative Nursing Management
343
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
343


