Kelly Michael A
Department of Orthopaedic Surgery, Hackensack University Medical Center, Hackensack, NJ; Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):S6-S8.
The opioid epidemic has become a national public health and safety problem affecting both adults and adolescents. There is little doubt that this epidemic is rooted in the need for pain control after surgery and that orthopedic surgeons have in part contributed to opioid overprescription. Indeed, opioid abuse, misuse, and diversion are associated with increased hospitalizations, emergency department visits, and associated health care costs. In addition, postoperative exposure to opioids correlates with long-term use and abuse.Moreover, opioid-related adverse effects are the leading cause of preventable harm in hospitals and can result in unexpected death. As such, there is an urgent need to address the opioid epidemic. Toward that end, several professional and governmental organizations have recommended opioid-sparing pain management approaches for surgeries-approaches that target different pain pathways to achieve adequate pain control. Such multimodal analgesia approaches are expected to reduce the writing of postoperative opioid prescriptions and their related adverse effects.
阿片类药物流行已成为一个影响成年人和青少年的全国性公共卫生与安全问题。毫无疑问,这场流行源于手术后疼痛控制的需求,而骨科医生在一定程度上促成了阿片类药物的过度处方。事实上,阿片类药物的滥用、误用和转移与住院人数增加、急诊就诊以及相关医疗保健费用有关。此外,术后接触阿片类药物与长期使用和滥用相关。此外,与阿片类药物相关的不良反应是医院可预防伤害的主要原因,可能导致意外死亡。因此,迫切需要解决阿片类药物流行问题。为此,几个专业和政府组织推荐了用于手术的阿片类药物节省型疼痛管理方法——这些方法针对不同的疼痛途径以实现充分的疼痛控制。预计这种多模式镇痛方法将减少术后阿片类药物处方的开具及其相关不良反应。