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The impact of pre-injury controlled substance use on clinical outcomes after trauma.伤前使用管制药品对创伤后临床结局的影响。
J Trauma Acute Care Surg. 2016 Nov;81(5):913-920. doi: 10.1097/TA.0000000000001229.
3
Preoperative Evaluation of the Patient with Substance Use Disorder and Perioperative Considerations.物质使用障碍患者的术前评估及围手术期注意事项
Anesthesiol Clin. 2016 Mar;34(1):201-11. doi: 10.1016/j.anclin.2015.10.015.
4
What Can a Urine Drug Screening Immunoassay Really Tell Us?尿液药物筛查免疫测定法究竟能告诉我们什么?
J Pharm Pract. 2016 Oct;29(5):516-26. doi: 10.1177/0897190015579611. Epub 2015 Apr 27.
5
Perioperative management in the patient with substance abuse.药物滥用患者的围手术期管理。
Surg Clin North Am. 2015 Apr;95(2):417-28. doi: 10.1016/j.suc.2014.11.001. Epub 2015 Jan 9.
6
The prevalence and impact of prescription controlled substance use among injured patients at a Level I trauma center.一级创伤中心受伤患者中处方管制物质使用的流行率和影响。
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7
Urine toxicology screening in Austrian trauma patients: a prospective study.奥地利创伤患者尿液毒理学筛查:一项前瞻性研究。
Arch Orthop Trauma Surg. 2010 Jul;130(7):883-7. doi: 10.1007/s00402-009-0995-5. Epub 2009 Nov 7.
8
Methamphetamines in trauma: effect on injury patterns and outcome.创伤中的甲基苯丙胺:对损伤模式和结局的影响。
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9
Outcomes of cocaine-positive trauma patients undergoing surgery on the first day after admission.入院后第一天接受手术的可卡因检测呈阳性的创伤患者的治疗结果。
J Trauma. 2008 Oct;65(4):809-12. doi: 10.1097/TA.0b013e318187803f.
10
Drug withdrawal, cocaine and sedative use disorders increase the need for mechanical ventilation in medical patients.药物戒断、可卡因和镇静剂使用障碍增加了内科患者对机械通气的需求。
Addiction. 2008 Sep;103(9):1500-8. doi: 10.1111/j.1360-0443.2008.002267.x.

醉酒创伤患者术中麻醉并发症风险增加?一项回顾性研究。

Are Intoxicated Trauma Patients at an Increased Risk for Intraoperative Anesthetic Complications? A Retrospective Study.

作者信息

Wolf Brian D, Munnangi Swapna, Pesso Raymond, McCahery Charles, Oad Madhu

机构信息

Resident of the Department of Oral and Maxillofacial Surgery, Nassau University Medical Center, East Meadow, New York, USA.

Division of Trauma, Department of Surgery, Nassau University Medical Center, East Meadow, New York, USA.

出版信息

Anesthesiol Res Pract. 2020 Mar 1;2020:2157295. doi: 10.1155/2020/2157295. eCollection 2020.

DOI:10.1155/2020/2157295
PMID:32190046
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7068141/
Abstract

BACKGROUND

The purpose of this study was to correlate intraoperative anesthetic complications of trauma patients with their respective urine toxicology results.

METHODS

This retrospective, single-center cohort study at a Level 1 trauma center included patients with the following criteria: (1) trauma admission between January 1, 2010, and December 31, 2016, (2) required surgical intervention, (3) are age 18 and older, and (4) urine toxicology screening was completed. Anesthetic records were evaluated for intraoperative complications.

RESULTS

The final analysis included 847 patients. The mean anesthesia time, American Society of Anesthesiologists physical status classification scores, change in body temperature, anesthetic complication rate, and mortality were not significantly different between urine toxicology positive and negative patients. Of note, a significantly lower proportion of the urine toxicology positive patients were extubated postoperatively in comparison to urine toxicology negative patients (57.32% vs 63.83%).

CONCLUSIONS

Trauma patients who presented with a positive urine toxicology screening are not at an increased risk for intraoperative anesthetic complications compared to those with a negative urine toxicology screening. However, our results indicated that the need for postoperative mechanical ventilation increased in the acutely intoxicated trauma patients when compared to those without preinjury intoxication.

摘要

背景

本研究的目的是将创伤患者的术中麻醉并发症与其各自的尿液毒理学结果相关联。

方法

这项在一级创伤中心进行的回顾性单中心队列研究纳入了符合以下标准的患者:(1)2010年1月1日至2016年12月31日期间因创伤入院,(2)需要手术干预,(3)年龄在18岁及以上,(4)完成了尿液毒理学筛查。对麻醉记录进行术中并发症评估。

结果

最终分析纳入了847例患者。尿液毒理学阳性和阴性患者之间的平均麻醉时间、美国麻醉医师协会身体状况分类评分、体温变化、麻醉并发症发生率和死亡率无显著差异。值得注意的是,与尿液毒理学阴性患者相比,尿液毒理学阳性患者术后拔管的比例显著更低(57.32%对63.83%)。

结论

与尿液毒理学筛查阴性的创伤患者相比,尿液毒理学筛查阳性的创伤患者术中麻醉并发症风险并未增加。然而,我们的结果表明,与无受伤前中毒的患者相比,急性中毒的创伤患者术后机械通气的需求增加。