通过住院患者的跌倒而持续的部骨折与较低的斜带块管理率和更高的阿片类药物需求有关:单中心体验
Hannah Jeal1, Matt Towner1, Joshua Moreau1
1Department of Trauma and Orthopaedics, Southmead Hospital, Bristol, GBR.
Cureus
|March 13, 2026
概括
作为住院病人入院的部骨折患者比急诊室患者接受的带 iliaca 阻塞 (FIB) 较少,导致阿片类药物使用率更高,住院时间更长. 这突显了护理差异,需要全医院的协议来及时进行区域麻醉.
科学领域:
- 老年学是指老年学的学科.
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
背景情况:
- 部骨折 (大腿部部 - NOF) 是老年人患病的重要原因.
- 有效的疼痛管理对于最大限度地减少阿片类药物相关的并发症,如妄想至关重要.
- 阴带块 (FIBs) 提供区域麻醉,可能减少阿片类药物需求.
研究的目的:
- 为了调查在住院住院期间发生的关节骨折的疼痛管理差异,与急诊室 (ED) 呈现相比.
- 为了比较FIBs的管理和随后的阿片类药物使用在这两组患者之间.
主要方法:
- 一个主要创伤中心的回顾性病例控制研究 (2019年1月 - 2020年12月).
- 将NOF的住院患者与年龄,性别,ASA等级,移动性和AMTS匹配的ED对照进行了比较.
- 主要结局:FIB的管理和24小时的阿片类药物使用 (口服吗啡等效剂量-OMED).
主要成果:
- 只有17%的住院患者接受了FIBs,而ED患者的比例为86% (P<0.001).
- 接受FIB的患者在24小时内对阿片类药物的需求显著降低 (17.3毫克与35.4毫克的OMED相比;P=0.037).
- 住院患者的术后停留时间较长 (41.5 vs. 15.2天;P=0.01).
结论:
- 与ED患者相比,患有NOF的住院患者接受FIB的可能性明显低.
- 这种差异与阿片类药物需求增加和长时间住院有关.
- 调查结果提倡全医院的协议,以确保所有NOF患者的公平区域麻醉.
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