Department of Dermatovenereology, West China Hospital of Sichuan University, Chengdu, 610041, China.
Department of Anesthesiology, Nanning Second People's Hospital, Nanning, 530031, China.
Sci Rep. 2018 May 9;8(1):7405. doi: 10.1038/s41598-018-25829-3.
Knowledge of illicit drug users (IDUs) is important because of the comorbidity related to drug use. In this prospective, observational study, we screened 1007 patients undergoing emergency surgery and found that 75 of them (7.5%) were IDUs The results of preoperative screening showed that the rates of HIV and syphilis infection were significantly higher in IDUs (HIV (+) 2.6%, syphilis (+) 10.7%) than in non-IDUs (HIV (+) 0, syphilis (+) 0.5%). Intraoperative consumption of remifentanil (IDUs: 1.85 ± 1.30 vs. non-IDUs: 1.31 ± 0.86, p = 0.009), midazolam (IDUs: 4.82 ± 1.52 vs. non-IDUs: 4.15 ± 1.81, p = 0.002), and atracurium (IDUs: 31.5 ± 15.1 vs. non-IDUs: 25.5 ± 11.9, p = 0.006) and the proportion of patients requiring postoperative fentanyl (IDUs: 15 (20.0%) vs. non-IDUs: 95 (1.2%), p = 0.031) were significantly increased in IDUs compared to non-IDUs. Postoperative complications were observed in 22.7% (17/75) of patients who were IDUs, which was significantly increased when compared with non-IDUs (6.0%, 56/932, p < 0.001). The mortality rate within 30 days after surgery was similar between the two groups. These findings suggested that the IDUs were associated with increased rates of HIV and syphilis infection; greater consumption of intraoperative opioids, sedatives, and muscle relaxants; increased postoperative complications and a similar mortality rate within 30 days after surgery when compared with non-IDUs.
了解非法药物使用者（IDUs）非常重要，因为与药物使用相关的合并症很多。在这项前瞻性、观察性研究中，我们对 1007 名接受急诊手术的患者进行了筛查，发现其中 75 名（7.5%）是 IDUs。术前筛查结果显示，IDUs 的 HIV 和梅毒感染率明显高于非 IDUs（HIV(+)2.6%，梅毒(+)10.7%）（HIV(+)0，梅毒(+)0.5%）。术中瑞芬太尼（IDUs：1.85±1.30 与非 IDUs：1.31±0.86，p=0.009）、咪达唑仑（IDUs：4.82±1.52 与非 IDUs：4.15±1.81，p=0.002）和阿曲库铵（IDUs：31.5±15.1 与非 IDUs：25.5±11.9，p=0.006）的消耗量以及需要术后芬太尼的患者比例（IDUs：15（20.0%）与非 IDUs：95（1.2%），p=0.031）在 IDUs 中明显高于非 IDUs。术后并发症在 75 名 IDUs 中观察到 22.7%（17/75），明显高于非 IDUs（6.0%，56/932，p<0.001）。两组术后 30 天内的死亡率相似。这些发现表明，与非 IDUs 相比，IDUs 与 HIV 和梅毒感染率增加、术中阿片类药物、镇静剂和肌肉松弛剂的消耗增加、术后并发症增加以及术后 30 天内死亡率相似有关。
