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术前阿片类药物教育对门诊骨科手术后阿片类药物消耗的影响:一项前瞻性随机试验。

The Effect of Preoperative Opioid Education on Opioid Consumption After Outpatient Orthopedic Surgery: A Prospective Randomized Trial.

出版信息

Orthopedics. 2021 Mar-Apr;44(2):123-127. doi: 10.3928/01477447-20210201-07. Epub 2021 Feb 10.

DOI:10.3928/01477447-20210201-07
PMID:33561870
Abstract

Pain management and opioid consumption following outpatient orthopedic surgery may be influenced by several variables, including knowledge of safe opioid use. A prospective randomized study was undertaken to understand the effect of preoperative opioid education on opioid consumption following outpatient orthopedic surgeries. A total of 237 patients undergoing outpatient orthopedic surgeries were prospectively randomized to receive preoperative opioid education or not. Postoperative data collected included the number of pills taken, daily visual analog scale (VAS) pain scores, adverse events, and attitude toward the pain experience. A total of 107 patients were randomized to receive preoperative education and 130 to not receive preoperative education. On average, 27 pills were prescribed to each patient. The preoperative opioid education group consumed significantly fewer opioids (6 pills) when compared with the group not receiving education (12 pills) (<.05). The findings were the same with upper and lower extremity surgeries. Overall, the 2 groups of patients had similar daily VAS scores and were satisfied with their postoperative pain experience irrespective of opioid education. Of the total opioid pills prescribed during the study, only 46% were ultimately consumed. Preoperative education significantly reduced the number of prescription opioid pills and total morphine equivalents consumed by patients in the period following outpatient orthopedic surgery, with no negative effects on pain experience. This finding was consistent in both upper and lower extremity surgery. Approximately twice the number of opioids were prescribed than ultimately consumed by patients. [. 2021;44(2):123-127.].

摘要

术后门诊骨科手术的疼痛管理和阿片类药物的使用可能会受到多种因素的影响,包括对安全使用阿片类药物的认识。一项前瞻性随机研究旨在了解术前阿片类药物教育对门诊骨科手术后阿片类药物使用的影响。共有 237 名接受门诊骨科手术的患者被前瞻性随机分为接受术前阿片类药物教育组或不接受术前阿片类药物教育组。收集的术后数据包括服用的药丸数量、每日视觉模拟量表(VAS)疼痛评分、不良反应以及对疼痛体验的态度。共有 107 名患者被随机分配接受术前教育,130 名患者未接受术前教育。平均每位患者开了 27 片药丸。与未接受教育组(12 片)相比,接受术前教育组(6 片)的阿片类药物消耗明显减少(<0.05)。上肢和下肢手术的结果相同。总的来说,2 组患者的每日 VAS 评分相似,并且无论是否接受阿片类药物教育,都对术后疼痛体验感到满意。在研究期间开出的所有阿片类药物中,只有 46%最终被服用。术前教育显著减少了门诊骨科手术后患者处方阿片类药物的数量和总吗啡等效物的消耗量,对疼痛体验没有负面影响。这一发现在上肢和下肢手术中都一致。患者最终服用的阿片类药物数量约为处方数量的两倍。

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