Komatsu Ryu, Singleton Michael D, Peperzak Katherin A, Wu Jiang, Dinges Emily M, Bollag Laurent A
Department of Anesthesiology and Pain Medicine, University of Washington, Box 356540, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA.
JA Clin Rep. 2022 Jun 21;8(1):45. doi: 10.1186/s40981-022-00535-2.
We tested the hypothesis that patients who continued buprenorphine postoperatively experience postoperative respiratory depression less frequently than those who discontinued buprenorphine.
This is a retrospective cohort study of patients who were on buprenorphine preoperatively. The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/minute, oxygen saturation (SpO) < 90%, or requirement of naloxone for 48 h postoperatively. The secondary outcome was the composite of postoperative respiratory complications. The associations between postoperative buprenorphine continuation and respiratory depression and respiratory complications were estimated using separate multivariable logistic regression models, including demographic, intraoperative characteristics, and preoperative buprenorphine dose as covariates.
Postoperative buprenorphine continuation was not associated with postoperative respiratory depression (adjusted odds ratio (OR), 1.11, 95% confidence interval (CI), 0.61 to 1.99, P=0.72). In subanalysis stratified by the preoperative buprenorphine dose, buprenorphine continuation was not associated with postoperative respiratory depression either when preoperative buprenorphine dose was high (≥16 mg daily) or low (<16 mg daily). Postoperative buprenorphine continuation was associated with lower incidence of postoperative respiratory complications (adjusted OR, 0.43, 95% CI, 0.21 to 0.86, P=0.02).
Continuing buprenorphine was not associated with respiratory depression, but it was associated with a lower incidence of respiratory complications.
我们检验了这样一个假设，即术后继续使用丁丙诺啡的患者发生术后呼吸抑制的频率低于停用丁丙诺啡的患者。
这是一项对术前使用丁丙诺啡患者的回顾性队列研究。主要结局是术后呼吸抑制，定义为呼吸频率<10次/分钟、氧饱和度（SpO）<90%或术后48小时内需要使用纳洛酮。次要结局是术后呼吸并发症的综合情况。使用单独的多变量逻辑回归模型评估术后丁丙诺啡继续使用与呼吸抑制和呼吸并发症之间的关联，将人口统计学、术中特征和术前丁丙诺啡剂量作为协变量。
术后继续使用丁丙诺啡与术后呼吸抑制无关（调整后的优势比（OR）为1.11，95%置信区间（CI）为0.61至1.99，P = 0.72）。在按术前丁丙诺啡剂量分层的亚分析中，当术前丁丙诺啡剂量高（≥16毫克/日）或低（<16毫克/日）时，继续使用丁丙诺啡也与术后呼吸抑制无关。术后继续使用丁丙诺啡与术后呼吸并发症发生率较低相关（调整后的OR为0.43，95%CI为0.21至0.86，P = 0.02）。
继续使用丁丙诺啡与呼吸抑制无关，但与呼吸并发症发生率较低相关。
