基于患者报告的阿片类药物使用量的关节镜下半月板部分切除术阿片类药物处方指南。
Opioid Prescribing Guidelines for Arthroscopic Partial Meniscectomy Based on Patient-reported Opioid Consumption.
机构信息
Anne Arundel Medical Center, Department of Orthopedics, Annapolis, Maryland.
出版信息
J Surg Orthop Adv. 2020 Winter;29(4):240-243.
The purpose of our study was to determine the optimum number of opioid pills and morphine milligram equivalents (MME) required to treat postoperative pain following arthroscopic partial meniscectomy. A retrospective cohort study of 77 patients undergoing arthroscopic partial meniscectomy between January, 2017 and May, 2019 was conducted. Of patients, 19.48% took no opioids following surgery. Patients were prescribed 84.34 ± 49.54 MME on average and took 28.23 ± 40.99 MME. This equated to an average of 16.52 ± 8.85 narcotic pills prescribed and 4.90 ± 6.26 pills taken. Of 77 patients, 66 (85.7%) took less than 10 total pills, and 57 (74.0%) took 5 or fewer. Patients undergoing arthroscopic partial meniscectomy are commonly overprescribed opioids postoperatively. On average, patients consumed just under five narcotic pills, less than one-third of the number prescribed. A standard prescription of 5 opioid pills or 25 MME is recommended for patients undergoing arthroscopic partial meniscectomy. (Journal of Surgical Orthopaedic Advances 29(4):240-243, 2020).
我们的研究目的是确定治疗关节镜下半月板部分切除术（arthroscopic partial meniscectomy）后术后疼痛所需的阿片类药物（opioid）丸数和吗啡毫克当量（morphine milligram equivalents，MME）的最佳数量。我们对 2017 年 1 月至 2019 年 5 月间接受关节镜下半月板部分切除术的 77 例患者进行了回顾性队列研究。术后，19.48%的患者未服用阿片类药物。患者平均开具 84.34 ± 49.54 MME，平均服用 28.23 ± 40.99 MME。这相当于平均开具 16.52 ± 8.85 片麻醉性镇痛药，服用 4.90 ± 6.26 片。在 77 例患者中，66 例（85.7%）服用的总药丸数少于 10 片，57 例（74.0%）服用的药丸数少于 5 片。关节镜下半月板部分切除术患者术后阿片类药物常常开具过多。平均而言，患者消耗的麻醉性镇痛药不到五片，不到处方数量的三分之一。建议接受关节镜下半月板部分切除术的患者处方标准为 5 片阿片类药物或 25 MME。（《外科矫形进步杂志》29(4):240-243，2020 年）。
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