Mohs 显微外科手术后阿片类药物处方与疼痛相关的患者主动沟通：一项回顾性队列研究。
Opioid Prescriptions and Pain-Related Patient-Initiated Communication After Mohs Micrographic Surgery: A Retrospective Cohort Study.
出版信息
J Drugs Dermatol. 2022 May 1;21(5):551-554. doi: 10.36849/JDD.5742.
BACKGROUND
There is a wide variety in utilization of opioids during Mohs Micrographic Surgery (MMS) despite evidence that a multimodality approach may be more beneficial.
OBJECTIVE
To evaluate prescription opioid use at our institution and subsequent pain-related patient communication following MMS.
METHODS
This was a retrospective cohort study involving 2360 patients who underwent MMS. Patient and operative characteristics in relation to opioid use in the peri-operative period were compared using univariate and bivariate statistical measures.
RESULTS
A total of 306 patients (13%) were prescribed opioids postoperatively. However, receipt of opioids is associated with greater odds of pain-related patient communication (OR=6.2; 95% CI:3.3–11.4). Opioid type was not significantly associated with reported pain (OR=0.7; 95% CI:0.3–1.8).
CONCLUSION
Consistent with existing guidelines, certain patient and operative characteristics such as age, number of Mohs stages, repair type, and anatomic site were associated with greater odds of receiving opioids. While certain patients may require opioids for adequate pain control, in our cohort, opioid use was associated with increased odds of pain-related patient communication post MMS. J Drugs Dermatol. 2022;21(5):551-554. doi:10.36849/JDD.5742.
背景
尽管有证据表明多模式方法可能更有益，但在 Mohs 显微外科手术 (MMS) 中，阿片类药物的使用存在很大差异。
目的
评估我们机构的阿片类药物处方使用情况以及随后 MMS 后与疼痛相关的患者沟通情况。
方法
这是一项回顾性队列研究，涉及 2360 名接受 MMS 的患者。使用单变量和双变量统计措施比较与围手术期阿片类药物使用相关的患者和手术特征。
结果
共有 306 名患者 (13%) 术后开处阿片类药物。然而，接受阿片类药物与疼痛相关的患者沟通的可能性更大 (OR=6.2；95%CI：3.3–11.4)。阿片类药物类型与报告的疼痛无显著相关性 (OR=0.7；95%CI：0.3–1.8)。
结论
与现有指南一致，某些患者和手术特征，如年龄、Mohs 阶段数、修复类型和解剖部位，与接受阿片类药物的可能性更大相关。虽然某些患者可能需要阿片类药物来控制疼痛，但在我们的队列中，MMS 后使用阿片类药物与疼痛相关的患者沟通增加的可能性相关。皮肤病药物杂志。2022；21(5):551-554。doi:10.36849/JDD.5742.
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