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创伤性脑损伤是否会在初级全膝关节整形术后增加阿片类药物的使用?

Bill Young¹, Dhruv Shankar², Cameron J Sabet³

¹Department of Orthopaedic Surgery, Stanford University, Stanford, California.

The Journal of arthroplasty

|December 19, 2025

概括

患有先前创伤性脑损伤 (TBI) 的患者在手术周围使用了更多的阿片类药物,并且在膝盖置换后更有可能继续长期使用它们. 这凸显了对接受骨科手术的TBI患者有针对性的疼痛管理策略的需要.

科学领域:

神经学神经学
整形外科手术整形外科手术
疼痛管理疼痛管理

背景情况:

创伤性脑损伤 (TBI) 是一种与增加疼痛和阿片类药物依赖相关的重大神经事件.
了解TBI对手术后疼痛管理的影响对于优化患者的治疗结果至关重要.

研究的目的:

评估先前创伤性脑损伤 (TBI) 对外科手术期间阿片类药物消费的影响.
为了评估长期使用阿片类药物的风险,在接受全膝关节整形手术 (TKA) 并且有TBI病史的患者中.

主要方法:

使用了大量的行政索赔数据库,识别了2010年至2022年的TKA患者.
患者根据先前的TBI诊断 (n=127,369) 与没有TBI (n=1,116,605) 进行分层.
术后的阿片类药物利用和持续的阿片类药物使用 (手术后90-180天) 是通过多变量回归分析的初级和二级结局.

主要成果:

与对照组 (896.7 MME) 相比,TBI队列的外科手术期间阿片类药物利用率 (987.5 MME) 显着更高.
持续使用阿片类药物在TBI队列 (17.5%) 和对照组 (14.5%) 中更为普遍.
在TKA的一年内先前的TBI诊断显著增加了持续阿片类药物使用的风险 (OR 1.20).

结论:

创伤性脑损伤 (TBI) 的病史与膝关节全关节整形术 (TKA) 后的术后阿片类药物使用增加有关.
患有先前TBI的患者在TKA后面临更长时间使用阿片类药物的可能性较高.
对潜在机制进行进一步的研究是有必要的,以开发针对这一患者群的有针对性的干预措施.

关键词:

膝关节关节整形手术膝关节关节整形手术这是一种阿片类阿片类药物.结果就是结果.手术手术手术手术手术手术手术创伤性脑损伤是一种创伤性脑损伤

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