在急诊室接触静脉注射类阿片六个月后持续使用类阿片的频率。前瞻性队列研究

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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引用次数: 0

摘要

背景随着阿片类药物使用障碍在普通人群中发病率的上升,一些人对静脉注射阿片类药物是否应常规用于急诊科(ED)急性剧烈疼痛的治疗提出了质疑。方法这是一项前瞻性观察性队列研究,在纽约布朗克斯区的两家急诊科进行。通过电话访问和查阅州阿片类药物处方数据库,对在急诊室接受静脉注射阿片类药物治疗的成年重度疼痛患者进行了 6 个月的随访。我们将持续使用阿片类药物定义为在急诊室就诊后的 6 个月内开出 6 张或更多阿片类药物处方,或平均每月开出一张处方。其中,506 名患者符合入选标准,并提供了可分析的数据。吗啡是急诊室最常使用的静脉注射阿片类药物(478 例,94%),其次是氢吗啡酮(20 例,4%)。在 506 人中,8 人(2%)同时接受了吗啡和氢吗啡酮静脉注射,63 人(12%)在急诊室就诊后被开具了阿片类药物处方。结论在 506 名因急性剧烈疼痛而接受静脉注射阿片类药物治疗的阿片类药物新手急诊患者中,只有一人在随后的 6 个月内持续使用阿片类药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study

Background

As rates of opioid use disorder in the general population have increased, some have questioned whether IV opioids should be used routinely for treatment of acute severe pain in the emergency department (ED).

Objectives

We determined the incidence of persistent opioid use among opioid-naïve patients exposed to IV opioids in the ED.

Methods

This was a prospective observational cohort study conducted in two EDs in the Bronx, NY. Opioid-naïve adults with severe pain who received IV opioids in the ED were followed-up 6 months later by telephone interview and review of the state opioid prescription database. We defined persistent opioid use as filling 6 or more prescriptions for opioids in the 6 months following the ED visit or an average of one prescription per month.

Results

We screened 1555 patients. Of these, 506 patients met entry criteria and provided analyzable data. Morphine was the IV opioid most frequently administered in the ED (478, 94%), followed by hydromorphone (20, 4%). Of the 506, 8 (2%) received both IV morphine and hydromorphone and 63 (12%) participants were prescribed an opioid for use after the ED visit. One patient/506 (0%) met our apriori criteria for persistent opioid use within 6 months.

Conclusion

Among 506 opioid naïve ED patients administered IV opioids for acute severe pain, only one used opioids persistently during the subsequent 6 months.

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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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