LaPietra Alexis M, Motov Sergey
Alexis M. LaPietra, DO, is Medical Director of Emergency Medicine Pain Management, Department of Emergency Medicine, St. Joseph's Health Wayne Hospital, Paterson, New Jersey.
Sergey Motov, MD, is Associate Research Director and Attending Physician, Department of Emergency Medicine, Maimonides Hospital, Brooklyn, New York.
Mo Med. 2019 Mar-Apr;116(2):140-145.
The United States is currently in the midst of an opioid epidemic that has led to previously unforeseen opioid misuse, abuse, and death. A major emphasis is being placed on reducing the exposure patients have to opioids, whenever possible, in an effort to hopefully reduce the risk of dependency, addiction, and overdose. However, opioid alternatives must be chosen carefully to ensure efficacy, safety, and availability for patients within the community. Non-opioid medications and modalities can reliably be used to treat not only opioid naive patients, keeping them opioid naive if possible, but also patients with opioid use disorders. Unfortunately, robust randomized controlled trials comparing non-opioid alternatives to opioids are lacking. Therefore, this review provides recommendations for best practices regarding improving pain management via the use of novel alternatives in the emergency department, medical wards and outpatient setting.
美国目前正处于阿片类药物流行之中，这导致了此前未曾预料到的阿片类药物滥用、成瘾及死亡情况。目前主要着重于尽可能减少患者接触阿片类药物的机会，以期降低依赖、成瘾和过量用药的风险。然而，必须谨慎选择阿片类药物的替代药物，以确保其对社区内患者的有效性、安全性及可及性。非阿片类药物和治疗方式不仅可可靠地用于治疗初次使用阿片类药物的患者，尽可能使其保持初次使用状态，还可用于治疗患有阿片类药物使用障碍的患者。不幸的是，缺乏将非阿片类替代药物与阿片类药物进行对比的有力随机对照试验。因此，本综述针对在急诊科、内科病房及门诊环境中通过使用新型替代药物改善疼痛管理的最佳实践提供了建议。
