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自报的大麻使用与择期手部手术患者的阿片类药物使用增加无关。

Self-reported cannabis use is not associated with greater opioid use in elective hand surgery patients.

机构信息

Department of Orthopaedic Surgery and Sports Medicine, University of Florida, 3450 Hull Road, Ste. 3301, Gainesville, FL, 32607, USA.

College of Medicine, University of Florida, Gainesville, FL, 32607, USA.

出版信息

Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1857-1862. doi: 10.1007/s00590-022-03321-z. Epub 2022 Aug 20.

Abstract

BACKGROUND

The purpose of this study was to examine the influence of preoperative marijuana use on postoperative opioid use during the first three postoperative days (POD 1-3) after surgery, and on expectations of pain control, resiliency, and quality-of-life scores.

METHODS

All patients presenting to a single institution undergoing elective hand or upper extremity outpatient surgery were asked to complete pre- and postoperative questionnaires. Preoperative questionnaires collected information on demographics, marijuana use, tobacco use, procedure type, self-assessed health, pain control expectations, and EuroQol-5D (EQ-5D) scores. At the first postoperative visit, patients self-reported opioid consumption from POD 1-3. Multivariate linear regression analysis was used to determine which patient characteristics were predictive of greater postoperative opioid consumption during POD 1-3.

RESULTS

Self-reported marijuana users were younger, less healthy, and more likely to use tobacco compared to non-users. Marijuana users and non-users were comparable in their use of pain medication (including non-opioids), rates of chronic pain diagnoses, and self-reported pain tolerance. EQ-5D scores were lower in marijuana users than non-users (0.64 vs. 0.72). Marijuana users and non-users were prescribed comparable quantities of opioids during the first 14 days after surgery (176 ± 148 vs 115 ± 87). Multiple linear regression analysis revealed that lower preoperative EQ-5D scores, rather than marijuana use, were associated with increased opioid consumption during POD 1-3.

CONCLUSIONS

Preoperative marijuana use was not independently associated with increased opioid use during POD 1-3 after elective hand and upper extremity surgery; instead, an association with lower preoperative EQ-5D scores was identified.

LEVEL OF EVIDENCE

II, prospective cohort study.

摘要

背景

本研究旨在探讨术前大麻使用对术后第 1-3 天(术后第 1-3 天)术后阿片类药物使用的影响,以及对疼痛控制、恢复力和生活质量评分的期望。

方法

所有在一家机构接受择期手部或上肢门诊手术的患者均被要求填写术前和术后问卷。术前问卷收集了人口统计学信息、大麻使用、吸烟情况、手术类型、自我评估健康状况、疼痛控制预期以及欧洲五维健康量表(EQ-5D)评分。在第一次术后就诊时,患者自我报告了从术后第 1-3 天的阿片类药物使用情况。采用多元线性回归分析确定哪些患者特征可预测术后第 1-3 天的阿片类药物消耗更大。

结果

与非使用者相比,自我报告的大麻使用者更年轻、健康状况较差,且更有可能吸烟。大麻使用者和非使用者在使用止痛药(包括非阿片类药物)、慢性疼痛诊断率和自我报告的疼痛耐受力方面相当。与非使用者相比,大麻使用者的 EQ-5D 评分较低(0.64 对 0.72)。在术后的前 14 天,大麻使用者和非使用者开具的阿片类药物剂量相当(176±148 对 115±87)。多元线性回归分析显示,术前 EQ-5D 评分较低,而不是大麻使用,与术后第 1-3 天阿片类药物消耗增加有关。

结论

术前大麻使用与择期手部和上肢手术后第 1-3 天的阿片类药物使用增加无关;相反,与术前 EQ-5D 评分较低有关。

证据水平

II,前瞻性队列研究。

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