接受美沙酮治疗的患者的全面围手术期管理注意事项。
Comprehensive Perioperative Management Considerations in Patients Taking Methadone.
机构信息
Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
Department of Anesthesiology, LSU Health Sciences Center New Orleans, Room 659, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
出版信息
Curr Pain Headache Rep. 2019 Jun 17;23(7):49. doi: 10.1007/s11916-019-0783-z.
PURPOSE OF REVIEW
Well-informed staff can help decrease risks and common misconceptions regarding opioid-tolerant patients, especially those taking methadone.
RECENT FINDINGS
In 2015, opioid pain relievers were the second most used drug at 3.8 million. Overdose death was three times greater in 2015 than in 2000. Medication-assisted treatment was sought by more than 2 million individuals with substance use disorder, one of which is methadone. Chronic pain affects millions of adults in the USA. Opioid therapy is widely used among these adults. Related to the risk of abuse and dependence, guidelines suggest that opioid therapy may not be considered first-line treatment. A multidisciplinary approach, including thorough preoperative evaluation, the utilization of multimodal pain management strategies, and opioid-sparing techniques in both the intraoperative and postoperative periods will allow for the best possible outcome.
目的综述
有见识的医护人员可以帮助减少阿片类药物耐受患者（尤其是服用美沙酮的患者）的风险和常见误解。
最新发现
2015 年，阿片类止痛药的使用率为 380 万，位居第二。与 2000 年相比，2015 年的药物过量致死率增加了两倍。有超过 200 万药物滥用者寻求药物辅助治疗，其中之一是美沙酮。慢性疼痛影响了美国数以百万计的成年人。阿片类药物疗法在这些成年人中广泛应用。由于存在滥用和依赖的风险，指南建议阿片类药物疗法可能不是一线治疗选择。多学科方法，包括彻底的术前评估、多模式疼痛管理策略的利用，以及术中及术后的减少阿片类药物使用技术，将可以获得最佳的治疗效果。
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