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在机器人辅助,计算机辅助和手动全关节整形手术中,住院期间的阿片类药物消费:一项回顾性队列研究
Periklis Giannakis1,2, Juliet E Rowe1, Renee Ren1
1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
BJA open
|February 13, 2026
概括
计算机辅助和机器人辅助的关节整形术 (THA) 显示阿片类药物消耗低于手动THA,特别是在术后第一天. 这些发现表明,技术辅助的THA对疼痛管理具有潜在的益处.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 医疗信息学 医疗信息学
背景情况:
- 在全关节整形术 (THA) 后,阿片类药物消费是一个重大问题.
- 不同的手术方法,包括手动 (MA-THA),计算机辅助 (CA-THA) 和机器人辅助 (RA-THA),可能会影响术后疼痛和阿片类药物使用.
研究的目的:
- 在住院期间对MA-THA,CA-THA和RA-THA的阿片类药物总消耗进行比较.
- 评估手术技术对特定术后几天的阿片类药物使用的影响.
主要方法:
- 使用Premier Healthcare数据库 (2016-2023) 进行的回顾性队列研究.
- 对584,578名接受单边选择性THA.治疗的患者进行分析.
- 两部分混合效应模型评估阿片类药物使用 (是/否) 和使用者之间的消费.
主要成果:
- 与MA-THA相比,CA-THA与任何阿片类药物使用的几率较低 (OR,0.87).
- 与CA-THA相比,RA-THA显示出任何阿片类药物使用的几率更高 (OR,1.22).
- 两种CA-THA和RA-THA都与使用者的阿片类药物总消费量比MA-THA低2%. 在术后第一天,CA-THA和RA-THA与MA-THA相比显著减少.
结论:
- 技术辅助的THA (CA-THA和RA-THA) 与MA-THA相比,与减少阿片类药物消费有关,特别是在早期的术后期.
- 虽然在临床上没有足够的意义来改变决策,但观察到的差异可能与麻醉技术有关,可以改善手术后立即缓解疼痛.
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