Levy Hannah A, Karamian Brian A, Henstenburg Jeffrey, Larwa Joseph, Canseco Jose A, Haislup Brett, Chang Michael, Patel Parthik, Radcliff Kris E, Woods Barrett I, Kurd Mark F, Hilibrand Alan S, Kepler Christopher K, Vaccaro Alexander R, Schroeder Gregory D
Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
J Orthop. 2021 Jun 30;26:23-28. doi: 10.1016/j.jor.2021.06.003. eCollection 2021 Jul-Aug.
This study aims to determine if preoperative weakness is an isolated risk factor for prolonged postoperative opioid use after anterior cervical discectomy and fusion (ACDF). Patients with preoperative weakness were significantly more likely to have prolonged and inappropriate opioid use and have a single prescription mean morphine equivalent (MME) ≥ 200. Logistic regression isolated preoperative weakness, opioid tolerance, depression, and VAS Neck pain as independent predictors of extended opioid use. High postoperative opioid dose (MME ≥ 90) correlated with opioid tolerance, younger age, male sex, greater CCI, prior cervical surgery, and preoperative VAS Neck pain on regression.
本研究旨在确定术前虚弱是否是颈椎前路椎间盘切除融合术（ACDF）后术后阿片类药物使用时间延长的独立危险因素。术前虚弱的患者更有可能长期不恰当地使用阿片类药物，且单次处方平均吗啡当量（MME）≥200。逻辑回归分析确定术前虚弱、阿片类药物耐受性、抑郁和视觉模拟评分法（VAS）颈部疼痛是阿片类药物使用时间延长的独立预测因素。术后高剂量阿片类药物（MME≥90）与阿片类药物耐受性、年轻、男性、更高的Charlson合并症指数（CCI）、既往颈椎手术以及回归分析中的术前VAS颈部疼痛相关。
