Fernandez Anne C, Lin Lewei A, Bazzi Angela R, Boissoneault Jeff, Borsari Brian, Blow Frederic
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Department of Psychiatry, University of Michigan and Center for Clinical Management Research, HSR&D, Veterans Affairs Health Care System, Ann Arbor, Michigan.
Pain Med. 2021 Oct 8;22(10):2384-2392. doi: 10.1093/pm/pnab104.
Elective surgical patients with unhealthy alcohol use have unique pain management needs and addiction risk factors that are relevant to surgical preparation and recovery. This descriptive qualitative study sought to better understand patients' beliefs and behaviors related to opioid use, alcohol use, and pain management in the perioperative context.
We conducted individual semi-structured interviews between July 2017 and March 2018.
A large Midwestern academic health system.
Participants were elective surgical patients meeting unhealthy alcohol use criteria, recruited from the health system's preoperative anesthesia clinic.
Semistructured interview guides explored beliefs and behaviors relating to alcohol and opioid use, health status, and surgical care. Interview recordings were transcribed and coded for thematic analysis.
Among 20 elective surgical patients (25% female), we identified three key themes regarding alcohol use, opioid use, and their co-use before and after surgery. First, desires and intentions to use opioids for postoperative pain management varied widely, even before opioids were prescribed. Second, some participants described alcohol as a preferred pain management strategy. Third, participants held a range of beliefs about the risks and benefits of alcohol and opioid co-use.
Appropriate assessment of beliefs and intentions regarding opioid and alcohol use could help identify patients most vulnerable to new opioid problems and unhealthy alcohol use in the context of perioperative surgical pain. These findings have important implications for perioperative pain management.
有不健康饮酒习惯的择期手术患者有独特的疼痛管理需求和成瘾风险因素，这些与手术准备和恢复相关。这项描述性定性研究旨在更好地了解患者在围手术期与阿片类药物使用、酒精使用和疼痛管理相关的信念和行为。
我们在2017年7月至2018年3月期间进行了个人半结构化访谈。
中西部一个大型学术医疗系统。
参与者是符合不健康饮酒标准的择期手术患者，从医疗系统的术前麻醉诊所招募。
半结构化访谈指南探讨了与酒精和阿片类药物使用、健康状况及手术护理相关的信念和行为。访谈录音被转录并编码以进行主题分析。
在20名择期手术患者（25%为女性）中，我们确定了关于手术前后酒精使用、阿片类药物使用及其联合使用的三个关键主题。首先，即使在开具阿片类药物之前，术后疼痛管理使用阿片类药物的愿望和意图也有很大差异。其次，一些参与者将酒精描述为首选的疼痛管理策略。第三，参与者对酒精和阿片类药物联合使用的风险和益处持有一系列信念。
对阿片类药物和酒精使用的信念和意图进行适当评估，有助于识别在围手术期手术疼痛背景下最易出现新的阿片类药物问题和不健康酒精使用的患者。这些发现对围手术期疼痛管理具有重要意义。
