皮肤手术后急性术后疼痛的阿片类药物处方
Opioid prescribing for acute postoperative pain after cutaneous surgery.
机构信息
Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota.
Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota.
出版信息
J Am Acad Dermatol. 2019 Mar;80(3):743-748. doi: 10.1016/j.jaad.2018.09.032. Epub 2018 Oct 2.
BACKGROUND
Little information is available to predict which patients require opioid analgesia following cutaneous surgery. When opioids are indicated, information regarding the optimal opioid agent selection and dosage is lacking.
OBJECTIVE
To make recommendations for opioid prescription after cutaneous surgery.
METHODS
A PubMed literature search was conducted to review the available literature. Recommendations are presented on the basis of available evidence and the opinion of the authors.
RESULTS
Most patients undergoing cutaneous surgery do not require opioid analgesia. For those who do, the duration of pain warranting opioid analgesia is generally less than 36 hours. Opioid refill requests warrant a follow-up visit to ascertain the cause of ongoing pain after excisional procedures.
LIMITATIONS
The recommendations are not based on prospective randomized trials.
CONCLUSIONS
The presented recommendations for opioid prescription practice are derived from available evidence, recommendations, and expert opinion.
背景
对于哪些患者在皮肤手术后需要使用阿片类镇痛药，目前相关信息较少。当需要使用阿片类药物时，关于最佳阿片类药物选择和剂量的信息也很缺乏。
目的
为皮肤手术后开具阿片类药物处方提供建议。
方法
对 PubMed 文献进行检索，以综述现有文献。基于现有证据和作者意见提出建议。
结果
大多数接受皮肤手术的患者不需要阿片类镇痛药。对于那些需要的患者，疼痛持续时间需要使用阿片类药物的时间通常小于 36 小时。对于阿片类药物的续开请求，需要进行随访以确定切除手术后持续疼痛的原因。
局限性
这些建议不是基于前瞻性随机试验。
结论
本文提出的阿片类药物处方实践建议是基于现有证据、建议和专家意见。
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