导致关节整形术后阿片类药物使用率较高的因素:来自大规模的第三级中心分析中心的见解
Andreas Fontalis1, Shannon Tse2, Mads K Hansen3
1Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK - Division of Surgery and Interventional Science, University College London, Gower Street, London, WC1E 6BT, UK.
SICOT-J
|February 3, 2026
概括
在全关节整形术 (THA) 后有效的疼痛管理是恢复的关键. 年龄较小,全身麻醉和PACU入院预测阿片类药物使用量较高,而晚年手术年份显示消费量较低.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 有效的术后疼痛管理对于关节整形术 (THA) 后的早期动员和恢复至关重要.
- 了解THA后阿片类药物消费模式对于优化患者的治疗结果至关重要.
- 这项研究旨在确定影响THA后住院阿片类药物使用的因素.
研究的目的:
- 在接受初级全关节整形手术 (THA) 的患者中调查住院阿片类药物消费的模式.
- 确定与THA后阿片类药物使用增加相关的人口,麻醉和手术因素.
- 为制定有针对性的疼痛管理策略提供信息.
主要方法:
- 分析了2019年4月至2023年7月期间进行的1,867个初级THA的数据.
- 收集有关患者人口统计,麻醉类型,PACU入院,Hb水平和阿片类药物消费 (MME) 的数据.
- 使用单变量和多变量逻辑回归模型来确定高阿片类药物消费 (≥75百分位) 的预测因素.
主要成果:
- 住院患者中位数的阿片类药物使用量为88毫克 (IQR 39.3-211.9).
- 较高阿片类药物消费的显著预测因素包括年龄较小,ASA得分较高,全身麻醉,PACU入院以及手术后Hb水平较低.
- 术后的几年与阿片类药物消费的减少有关 (OR 0.638).
结论:
- 年龄较小,ASA分数较高,手术后血红蛋白较低,PACU入院和全身麻醉与THA后阿片类药物消费增加有显著联系.
- 识别这些因素可以开发个性化疼痛管理协议.
- 有针对性的干预措施可以最大限度地减少阿片类药物依赖,并改善THA后的恢复途径.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
1.1K
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...
1.1K
Tertiary Healthcare System
2.2K
Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care...
2.2K
Opioid Receptors: Overview
4.4K
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,...
4.4K
Nomenclature of Secondary and Tertiary Amines
5.2K
The secondary and tertiary amines are derivatives of ammonia, where two and three of its hydrogens are replaced by alkyl groups, respectively. Secondary and tertiary amines can be symmetrical with identical alkyl groups attached to the nitrogen atom or unsymmetrical when more than one type of alkyl group is present. The standard nomenclature of secondary and tertiary amines is similar to the names given to the primary amines. They are generally named alkylamines. As depicted in Figure 1, for...
5.2K
pH Scale
79.9K
Hydronium and hydroxide ions are present both in pure water and in all aqueous solutions, and their concentrations are inversely proportional as determined by the ion product of water (Kw). The concentrations of these ions in a solution are often critical determinants of the solution’s properties and the chemical behaviors of its other solutes. Two different solutions can differ in their hydronium or hydroxide ion concentrations by a million, billion, or even trillion times. A common means of...
79.9K
Energy to Drive Translocation
2.8K
Mitochondrial protein import is powered by two distinct energy sources: ATP hydrolysis and electrochemical potential across the inner membrane. Newly synthesized precursors are bound by cytosolic chaperones of the Hsp70 family, which guide them to the import receptors on the mitochondrial surface. Utilizing the energy of ATP hydrolysis, Hsp70 chaperones transfer these precursors to the TOM receptors on the mitochondrial outer membrane.
Generally, polypeptides are unfolded by two distinct...
Generally, polypeptides are unfolded by two distinct...
2.8K


