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使用消遣性大麻的骨科手术患者术前疼痛更少。

Orthopaedic surgery patients who use recreational marijuana have less pre-operative pain.

机构信息

Department of Orthopaedics, University of Maryland School of Medicine, University of Maryland Rehabilitation and Orthopaedic Institute, 2200 Kernan Drive, Baltimore, MD, 21207, USA.

Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.

出版信息

Int Orthop. 2019 Feb;43(2):283-292. doi: 10.1007/s00264-018-4101-x. Epub 2018 Aug 22.

Abstract

AIMS

To determine the baseline clinical characteristics of recreational marijuana users undergoing outpatient orthopaedic surgery. We hypothesized that patients who report marijuana use would have worse pain, function, and general health status.

PATIENTS AND METHODS

Nine-hundred and thirty-seven patients undergoing outpatient orthopaedic surgery were asked to fill out patient-reported outcome (PRO) tools. These PROs included the Patient-Reported Outcomes Measurement Information Systems (PROMIS) computer adaptive tests and legacy PROs unique to each patients' surgical site.

RESULTS

Forty patients (4.2%) reported marijuana use. Marijuana use was associated with younger age (33 vs. 43 years, p < 0.001), having a history of fewer operations (1.8 vs. 3.2, p < 0.05), single marital status (68 vs. 38%, p < 0.01), and having a history of smoking cigarettes (63 vs. 31%, p < 0.0001). Marijuana use was found to be significantly associated with greater Marx lower extremity activity rating scale scores (8.5 points vs. 6.1 points, p < 0.05) and decreased pain intensity in the operative site (3.7 points vs. 5.0 points, p < 0.05). Multivariable analysis found that marijuana use was an independent factor associated with less pain intensity in the operative site (p < 0.05).

CONCLUSION

Our studies support other national studies that report increased marijuana use among younger patients and those who smoke cigarettes. The results do not support our hypothesis, as marijuana use was associated with less pain and better lower extremity activity rating scale scores when compared to non-users. Further research is warranted to analyze the effects of marijuana use on orthopaedic surgery patients.

STUDY DESIGN

Cross-sectional study.

摘要

目的

确定接受门诊骨科手术的娱乐性大麻使用者的基线临床特征。我们假设报告大麻使用情况的患者疼痛、功能和一般健康状况会更差。

方法

937 名接受门诊骨科手术的患者被要求填写患者报告的结果(PRO)工具。这些 PRO 包括患者报告的结果测量信息系统(PROMIS)计算机自适应测试和每个患者手术部位特有的传统 PRO。

结果

40 名患者(4.2%)报告了大麻使用情况。大麻使用与年龄较小(33 岁与 43 岁,p<0.001)、手术次数较少(1.8 次与 3.2 次,p<0.05)、单身婚姻状况(68%与 38%,p<0.01)和吸烟史(63%与 31%,p<0.0001)有关。大麻使用与 Marx 下肢活动评分较高(8.5 分与 6.1 分,p<0.05)和手术部位疼痛强度降低(3.7 分与 5.0 分,p<0.05)显著相关。多变量分析发现,大麻使用是与手术部位疼痛强度降低相关的独立因素(p<0.05)。

结论

我们的研究支持其他国家的研究报告,即年轻患者和吸烟患者中大麻使用增加。结果并不支持我们的假设,因为与非使用者相比,大麻使用者的疼痛较轻,下肢活动评分较高。需要进一步研究来分析大麻使用对骨科手术患者的影响。

研究设计

横断面研究。

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