Blågestad Tone, Nordhus Inger H, Grønli Janne, Engesæter Lars B, Ruths Sabine, Ranhoff Anette H, Bjorvatn Bjørn, Pallesen Ståle
Department of Clinical Psychology, University of Bergen, Bergen, Norway Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway Sleep and Performance Research Center, College of Medical Sciences, Washington State University, Spokane, WA, USA Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Orthopaedics, Haukeland University Hospital, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Research Unit for General Practice, Uni Research Health, Bergen, Norway Kavli Research Center for Ageing and Dementia, Haraldsplass Hospital, Bergen, Norway Department of Clinical Science, University of Bergen, Bergen, Norway Diakonhjemmet Hospital, Oslo, Norway The Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Psychosocial Science, University of Bergen, Bergen, Norway.
Pain. 2016 Mar;157(3):643-651. doi: 10.1097/j.pain.0000000000000414.
Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, this study sought to investigate redeemed medications in a complete population (N = 39,688) undergoing THA in 2005 to 2011. User rates and redeemed drug volume of analgesics (nonsteroid anti-inflammatory drugs (NSAIDs), opioids, and nonopioids) and psychotropics (hypnotics, anxiolytics, and antidepressants) were calculated for 4 quarters before and 4 quarters after surgery. We analysed preoperative prescription trends (Q1 vs Q4), postoperative prescription (Q4 vs Q5), and long-term effect of surgery (Q4 vs Q8). Before surgery, use of all drug groups increased from Q1 to Q4. Use of opioids, nonopioids, and hypnotics dramatically increased from Q4 to Q5. Long-term (Q4 vs Q8) surgery reduced prescriptions of analgesics, hypnotics, and anxiolytics, but not antidepressants. Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms.
全髋关节置换术（THA）已被证明能减轻疼痛并改善功能。此外，有研究表明THA能改善睡眠并缓解焦虑和抑郁症状。慢性疼痛患者经常使用镇痛药和精神药物，因此存在药物不良事件的风险。THA对这类药物使用的影响尚未得到充分研究。基于挪威处方数据库和挪威关节成形术登记处的合并数据，本研究旨在调查2005年至2011年期间接受THA的全体人群（N = 39,688）的药物赎回情况。计算了手术前4个季度和手术后4个季度镇痛药（非甾体抗炎药（NSAIDs）、阿片类药物和非阿片类药物）和精神药物（催眠药、抗焦虑药和抗抑郁药）的使用率和赎回药物量。我们分析了术前处方趋势（第1季度与第4季度）、术后处方（第4季度与第5季度）以及手术的长期影响（第4季度与第8季度）。手术前，所有药物组的使用量从第1季度到第4季度均有所增加。从第4季度到第5季度，阿片类药物、非阿片类药物和催眠药的使用量大幅增加。长期来看（第4季度与第8季度），手术减少了镇痛药、催眠药和抗焦虑药的处方，但抗抑郁药的处方未减少。总体而言，目前的结果扩展了THA的积极作用，包括减少对药物缓解症状的依赖。
