Adams Alexander J, Ilyas Asif M
Department of Orthopedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
Rothman Opioid Foundation, Philadelphia, PA.
J Hand Surg Glob Online. 2022 Aug 16;4(5):276-282. doi: 10.1016/j.jhsg.2022.06.006. eCollection 2022 Sep.
The United States' opioid epidemic has taken an immense toll over the past 2 decades when assessed by morbidities, mortalities, and economic costs. Prescription opioids are a substantial contribution to this public health emergency, and it is critical for health care providers to practice good analgesic stewardship. Interventions have effectively curtailed opioid overuse, including prescription drug monitoring programs, educational initiatives, and multimodal analgesia strategies. Surgeons, particularly hand surgeons or those who perform musculoskeletal procedures, have been implicated as high-volume opioid prescribers. Guidelines for appropriate opioid dosing and analgesic management strategies after common hand and upper-extremity surgeries are sparse and offer an area for meaningful improvement. We sought to generate comprehensive, evidence-based recommendations for postoperative analgesia regimens for common hand and upper-extremity procedures.
在过去20年里，从发病率、死亡率和经济成本方面评估，美国的阿片类药物流行造成了巨大损失。处方阿片类药物是这场公共卫生紧急事件的一个重要因素，对医疗保健提供者而言，实施良好的镇痛管理至关重要。一些干预措施有效地减少了阿片类药物的过度使用，包括处方药监测计划、教育倡议和多模式镇痛策略。外科医生，尤其是手外科医生或那些进行肌肉骨骼手术的医生，被认为是大量开具阿片类药物处方的人。关于常见手部和上肢手术后适当阿片类药物剂量及镇痛管理策略的指南很少，这是一个有显著改进空间的领域。我们试图为常见手部和上肢手术的术后镇痛方案制定全面的、基于证据的建议。
