Veal Felicity, Thompson Angus, Halliday Samuel, Boyles Peter, Orlikowski Chris, Bereznicki Luke
Unit for Medication Outcomes Research & Education (UMORE), School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia.
Department of Health, Hobart, Tasmania, Australia.
J Pain Res. 2020 Apr 5;13:703-708. doi: 10.2147/JPR.S235764. eCollection 2020.
Acute pain is common following surgery, with opioids frequently employed in its management. Studies indicate that commencing an opioid during a hospital admission increases the likelihood of long-term use. This study aimed to identify the prevalence of opioid persistence amongst opioid-naïve patients following surgery as well as the indication for use.
A retrospective review of patients who underwent a surgical procedure at the Royal Hobart Hospital, Tasmania, Australia, between August and September 2016 was undertaken. Patients were linked to the Tasmanian real-time prescription monitoring database to ascertain if they were subsequently dispensed a Schedule 8 opioid (morphine, codeine oxycodone, buprenorphine, hydromorphone, fentanyl, methadone, or tapentadol) and the indication for use.
Of the 3275 hospital admissions, 1015 opioid-naïve patients were eligible for inclusion. Schedule 8 opioids were dispensed at or within 2 days of discharge in 41.7% of admissions. Thirty-nine (3.9%) patients received prescribed opioids 2-months post-discharge; 1.8% of the patients were approved by State Health to be prescribed Schedule 8 opioids regularly for a chronic condition at 6 months, and 1.3% received infrequent or one-off prescriptions for Schedule 8 opioids at 6 months. Thirteen (1.3%) patients continued Schedule 8 opioids for at least 6 months following their surgery, with the indication for treatment either related to the surgery or the condition which surgery was sought for.
This study found that there was a low rate of Schedule 8 opioid persistence following surgery, indicating post-surgical pain is not a significant driver for persistent opioid use.
急性疼痛在手术后很常见，阿片类药物常用于其治疗。研究表明，住院期间开始使用阿片类药物会增加长期使用的可能性。本研究旨在确定初次使用阿片类药物的患者术后阿片类药物持续使用的发生率及其使用指征。
对2016年8月至9月在澳大利亚塔斯马尼亚州皇家霍巴特医院接受手术的患者进行回顾性研究。将患者与塔斯马尼亚实时处方监测数据库进行关联，以确定他们随后是否获得了8类阿片类药物（吗啡、可待因、羟考酮、丁丙诺啡、氢吗啡酮、芬太尼、美沙酮或曲马多）及其使用指征。
在3275例住院病例中，1015例初次使用阿片类药物的患者符合纳入标准。41.7%的患者在出院时或出院后2天内获得了8类阿片类药物。39例（3.9%）患者在出院后2个月接受了阿片类药物处方；1.8%的患者在6个月时获得州卫生部门批准，因慢性病定期开具8类阿片类药物；1.3%的患者在6个月时接受了8类阿片类药物的不定期或一次性处方。13例（1.3%）患者在手术后持续使用8类阿片类药物至少6个月，治疗指征与手术或手术所治疗的疾病相关。
本研究发现，术后8类阿片类药物持续使用的发生率较低，表明术后疼痛并非持续使用阿片类药物的主要驱动因素。
