Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Am J Perinatol. 2020 Mar;37(4):390-397. doi: 10.1055/s-0039-1678566. Epub 2019 Feb 12.
This study aimed to determine the receipt of short-acting opioid medications during vaginal delivery hospitalizations.
The Perspective database was analyzed to evaluate patterns of short-acting oral opioid use during vaginal delivery hospitalizations from January 2006 to March 2015. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating use of opioids. Hospital-level rates of opioid use were evaluated. Opioid receipt among women with opioid abuse or dependence was evaluated based on overall hospital rates of opioid use.
Of 3,785,396 vaginal delivery hospitalizations from 2006 to 2015, 1,720,899 (45.5%) women received an oral opioid for pain relief. Opioid use varied significantly among the 458 hospitals included in the analysis, with one-third of hospitals providing opioids to <38% of patients, one-third to 38 to <59% of patients, and one-third to ≥59% of patients. When hospitals were stratified by overall opioid administration rates, women with opioid abuse or dependence were less likely to be given opioids in hospitals with low overall opioid rates.
The use of opioid pain medications during vaginal delivery hospitalizations varied significantly among hospitals, suggesting that standardization of pain management practices could reduce opioid use.
本研究旨在确定阴道分娩住院期间是否使用了短效阿片类药物。
分析 Perspective 数据库，以评估 2006 年 1 月至 2015 年 3 月阴道分娩住院期间短期口服阿片类药物使用的模式。创建了未调整和调整模型，以评估人口统计学和医院因素在评估阿片类药物使用中的作用。评估了医院级别的阿片类药物使用率。根据总体医院阿片类药物使用率，评估了阿片类药物滥用或依赖的女性接受阿片类药物的情况。
在 2006 年至 2015 年的 3785396 例阴道分娩住院患者中，1720899 例（45.5%）女性接受了口服阿片类药物缓解疼痛。在纳入分析的 458 家医院中，阿片类药物的使用差异显著，其中三分之一的医院给<38%的患者提供阿片类药物，三分之一到 38%到<59%的患者，三分之一到≥59%的患者。当按总体阿片类药物给药率对医院进行分层时，在阿片类药物总体使用率较低的医院中，阿片类药物滥用或依赖的女性接受阿片类药物的可能性较小。
阴道分娩住院期间阿片类药物止痛药物的使用在医院之间差异显著，表明疼痛管理实践的标准化可能会减少阿片类药物的使用。
