非甾体抗炎药对截骨愈合和阿片类药物消耗的可变影响。
The Variable Effects of NSAIDs on Osteotomy Healing and Opioid Consumption.
机构信息
Department of Clinical Orthopaedics, Weill Medical College of Cornell University, The Hospital for Special Surgery (Dr. Fragomen and Dr. Rozbruch); Limb Lengthening and Complex Reconstruction Service, The Hospital for Special Surgery (Dr. Fragomen and Dr. Rozbruch); Hospital for Special Surgery (Ms. Suh), New York, NY; Geisinger Commonwealth School of Medicine, Scranton, PA (Ms. Matta); Department of Medicine and Psychiatry, Harvard Medical School, Center for Quantitative Health, Simches Research Building, Massachusetts General Hospital and Harvard Medical School (Dr. McCoy); and Center for Quantitative Health, Simches Research Building, Massachusetts General Hospital and Harvard Medical School (Ms. Hart), Boston, MA.
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2020 Apr 6;4(4). doi: 10.5435/JAAOSGlobal-D-20-00039. eCollection 2020 Apr.
UNLABELLED
In an effort to fight the opioid epidemic, an NSAID pain protocol was created for osteotomy patients. The study asked if NSAIDs negatively affect bone healing or reduce the need for opioids.
METHODS
This was a retrospective review of 155 limbs that underwent osteotomy of a long bone with fixation. Patients received an NSAID-free protocol or an NSAID protocol. Time to union and bone healing index were recorded.
RESULTS
There was not a significant difference in the time to union ( = 0.89) or bone healing index ( = 0.07). In the deformity correction group, the total milligrams of morphine equivalents prescribed after discharge was significantly less in patients receiving NSAIDs ( < 0.001).
CONCLUSIONS
The use of NSAIDs after osteotomy surgery did not negatively affect bone healing and resulted in a dramatic decrease in narcotic consumption for deformity correction patients.
LEVEL OF EVIDENCE
Level III retrospective cohort study.
背景
为了应对阿片类药物泛滥的问题，我们为接受截骨术的患者制定了 NSAID 止痛方案。本研究旨在探讨 NSAIDs 是否会对骨骼愈合产生负面影响或减少对阿片类药物的需求。
方法
本研究回顾性分析了 155 例行长骨切开复位内固定术的患者。患者接受 NSAID 无禁忌证方案或 NSAID 方案。记录愈合时间和骨愈合指数。
结果
两组患者的愈合时间（ = 0.89）或骨愈合指数（ = 0.07）无显著差异。在畸形矫正组中，接受 NSAIDs 治疗的患者出院后开具的吗啡等效物总剂量明显减少（ < 0.001）。
结论
截骨术后使用 NSAIDs 不会对骨骼愈合产生负面影响，并显著减少畸形矫正患者对阿片类药物的需求。
证据等级
III 级回顾性队列研究。
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