一组手术患者阿片类药物使用的相关因素

Q2 Medicine
Jennifer M. Hah, Y. Sharifzadeh, Bing Wang, M. Gillespie, S. Goodman, S. Mackey, Ian R Carroll
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引用次数: 31

摘要

目标。术前服用阿片类药物的患者术后阿片类药物使用时间延长,临床结果更差,疼痛增加,术后并发症更多。我们的目的是比较术前阿片类药物使用者与阿片类药物naïve对应者,以确定基线特征的差异。方法:在一项横断面研究中,对107例接受开胸、全膝关节置换术、全髋关节置换术、根治性乳房切除术和乳房肿瘤切除术的患者进行调查,以表征疼痛测量、物质使用、滥用、成瘾、睡眠和心理测量(抑郁症状、创伤后应激障碍症状、躯体恐惧和焦虑以及对疼痛的恐惧)与阿片类药物使用之间的关系。结果。疼痛修正患者的筛查和阿片类药物评估(soap - r)评分每增加9分,术前阿片类药物使用几率增加2.37 (95% CI 1.29-4.32) (p = 0.0005)。soap - r评分也与术前非法使用阿片类药物的几率增加3.02 (95% CI 1.36-6.70)相关(p = 0.007)。此外,未来手术部位基线疼痛每增加4个点,术前合法使用阿片类药物的几率增加2.85 (95% CI 1.12-7.27) (p = 0.03)。讨论。术前使用阿片类药物的患者有较高的soap - r评分,可能表明手术后阿片类药物滥用的风险增加。此外,术前合理使用阿片类药物与先前存在的疼痛有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Associated with Opioid Use in a Cohort of Patients Presenting for Surgery
Objectives. Patients taking opioids prior to surgery experience prolonged postoperative opioid use, worse clinical outcomes, increased pain, and more postoperative complications. We aimed to compare preoperative opioid users to their opioid naïve counterparts to identify differences in baseline characteristics. Methods. 107 patients presenting for thoracotomy, total knee replacement, total hip replacement, radical mastectomy, and lumpectomy were investigated in a cross-sectional study to characterize the associations between measures of pain, substance use, abuse, addiction, sleep, and psychological measures (depressive symptoms, Posttraumatic Stress Disorder symptoms, somatic fear and anxiety, and fear of pain) with opioid use. Results. Every 9-point increase in the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) score was associated with 2.37 (95% CI 1.29–4.32) increased odds of preoperative opioid use (p = 0.0005). The SOAPP-R score was also associated with 3.02 (95% CI 1.36–6.70) increased odds of illicit preoperative opioid use (p = 0.007). Also, every 4-point increase in baseline pain at the future surgical site was associated with 2.85 (95% CI 1.12–7.27) increased odds of legitimate preoperative opioid use (p = 0.03). Discussion. Patients presenting with preoperative opioid use have higher SOAPP-R scores potentially indicating an increased risk for opioid misuse after surgery. In addition, legitimate preoperative opioid use is associated with preexisting pain.
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来源期刊
Pain Research and Treatment
Pain Research and Treatment Medicine-Anesthesiology and Pain Medicine
CiteScore
3.60
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0.00%
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