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阿片类耐受患者:阿片类药物优化。

The Opioid-Tolerant Patient: Opioid Optimization.

机构信息

Department of Anesthesiology, Duke University Medical Center, Durham, NC.

出版信息

J Arthroplasty. 2020 Jun;35(6S):S50-S52. doi: 10.1016/j.arth.2020.01.001. Epub 2020 Jan 10.

Abstract

Chronic opioid use and abuse continue to plague our country despite efforts to curtail their use. Patients on chronic opioids (opioids tolerant) who undergo total joint arthroplasty have been clearly shown to have higher rates of complications, infection, and early revision compared to the opioid-naïve patients. The ability to successfully wean patients off of narcotics before surgery remains challenging and fragmented at best. The utilization of a multidisciplinary team that assists with not only preoperative opioids reduction but also postoperative opioids management is critical to the successful management of these patients. This symposium focuses on the opioid-tolerant patients and a comprehensive approach to opioids optimization.

摘要

尽管我们已经采取了措施来控制阿片类药物的使用,但慢性阿片类药物的使用和滥用仍在困扰着我们的国家。接受全关节置换术的慢性阿片类药物(阿片类药物耐受)患者与阿片类药物初治患者相比,并发症、感染和早期翻修的发生率明显更高。在手术前成功使患者戒掉麻醉性镇痛药仍然极具挑战性,而且最多也只是零碎地成功。利用多学科团队不仅可以帮助减少术前阿片类药物的使用,还可以帮助管理术后阿片类药物的使用,这对这些患者的成功治疗至关重要。本次专题研讨会重点讨论了阿片类药物耐受患者和阿片类药物优化的综合方法。

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