Demsey Daniel, Carr Nicholas J, Clarke Hance, Vipler Sharon
Vancouver, British Columbia; and Toronto, Ontario, Canada.
From the Division of Plastic Surgery and the Fraser Health Substance Use Services, University of British Columbia; and the Department of Anaesthesia and Pain Management, University of Toronto, Toronto General Hospital.
Plast Reconstr Surg. 2017 Oct;140(4):613e-619e. doi: 10.1097/PRS.0000000000003742.
Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder. This review gives an update of the current state of the opioid crisis, explains how current surgeons' prescribing practices are contributing to it, and gives recommendations on how to use opioid medication safely in the perioperative period.
阿片类药物成瘾是一场影响医学各个领域的公共卫生危机。所有种族和经济层面的大量人群滥用处方阿片类药物并使用非法阿片类药物。目前的认识是，阿片类药物滥用是一种需要治疗的疾病，而非选择或性格问题。使用阿片类药物是术后镇痛的必要组成部分，但鉴于患者有发生阿片类药物滥用障碍的风险，许多医生不确定如何安全地做到这一点。本综述介绍了阿片类药物危机的当前状况，解释了当前外科医生的处方行为如何助长了这一危机，并就如何在围手术期安全使用阿片类药物给出了建议。
