少一个:单切口腹腔镜阑尾切除术促进术后阿片类药物的避免。

IF 1.1 4区 医学 Q3 SURGERY
Paul M Jeziorczak, Casey J Goodyear, Olivia A Perham, Riley S Frenette, Charles J Aprahamian
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引用次数: 0

摘要

背景:阿片类药物使用已成为一个流行病问题。最近一直在推动减少术后阿片类药物使用的策略。阑尾切除术是儿科人群中最常见的手术之一。通过脐部的单切口阑尾切除术是一种安全且耐受性良好的手术。本项目的目的是回顾阿片类药物在接受单切口阑尾切除术治疗穿孔和非穿孔阑尾炎的儿童中的应用。方法:经伊利诺伊大学医学院机构审查委员会批准,对2018年5月1日至2021年12月1日期间在一家机构接受阑尾切除术的500名18岁以下患者进行回顾性分析。在排除非单切口病例(67例)和非阑尾切除术病例(1)后,最终的人群队列为432人。感兴趣的结果是住院时间、年龄、阑尾穿孔状况和出院时的阿片类药物。所有患者出院时都没有使用阿片类药物。结果:共432例患者行单切口腹腔镜阑尾切除术,总体平均住院时间为2.1天,平均年龄为11.1岁,零例患者因阿片类药物出院。阑尾穿孔人群(n = 169)住院时间少于4天,平均年龄10.33岁,61.5%为男性。同时,未穿孔的阑尾患者(n = 264)的住院时间为0.8天,平均年龄为11.59岁,男性占54.2%。穿孔阑尾切除术与非穿孔阑尾切除术在平均住院时间(P < 0.001)和平均年龄(P < 0.01)上差异有统计学意义。结论:认识阿片类药物在术后疼痛控制管理中的应用,对解决当前的阿片类药物危机具有重要意义。单切口腹腔镜小儿阑尾切除术可以潜在地减少术后麻醉的需要。在我们的人口中,没有孩子被带着毒品送回家。该手术具有良好的耐受性,可以使用传统的腹腔镜设备进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
One Less: Single-Incision Laparoscopic Appendectomy Facilitates Postoperative Opioid Avoidance.

Background: Opioid use has become an epidemic problem. There has been a recent push toward strategies that minimize postoperative opioid use. Appendectomy is one of the most common procedures performed in the pediatric population. Single-incision appendectomy through the umbilicus is a safe and well-tolerated procedure. The aim of this project was to review opioid utilization in children who have undergone single incision appendectomy for perforated and nonperforated appendicitis. Methods: A retrospective review, approved by the University of Illinois College of Medicine Institutional Review Board, of 500 patients at a single institution under the age of 18 who had an appendectomy between May 1, 2018, and December 1, 2021, was performed. A final population cohort of 432 was assembled after excluding non-single-incision cases (67) and non-appendectomy cases (1). Outcomes of interest were length of stay, age, appendix perforation status, and opioids at discharge status. All patients were sent home without opioids. Results: A total of 432 patients underwent a single incision laparoscopic appendectomy, with an overall average length of stay of 2.1 days, average age of 11.1 years, and zero patients were sent home on opioids. The perforated appendix population (n = 169) yielded a less than 4-day stay, an average age of 10.33 years, and 61.5% male. Meanwhile, the nonperforated appendix population (n = 264) revealed a 0.8-day stay, an average age of 11.59, years and 54.2% male. The differences between perforated and nonperforated appendectomies are significant for average length of stay (P < .001) and average age (P < .01). Conclusion: Being cognizant of opioid utilization in the management of postoperative pain control is important to address the current opioid crisis. The single incision laparoscopic approach for pediatric appendectomy can potentially decrease the need for postoperative narcotics. No children were sent home with narcotics in our population. The procedure is well tolerated and can be performed with traditional laparoscopic equipment.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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