三级医院中阿片类药物引起的呼吸抑制及危险因素：一项回顾性研究。
Opioid-induced respiratory depression and risk factors in a tertiary hospital: A retrospective study.
作者信息
Almouaalamy Nabil A, Alshamrani Majed, Alnejadi Waleed K, Alharbi Ziyad M, Aldosari Faisal M, Alsulimani Enad F, Saif Saif A, Aldawsari Mohammed K
机构信息
Oncology Department, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia.
出版信息
Saudi Pharm J. 2022 Aug;30(8):1095-1100. doi: 10.1016/j.jsps.2022.06.004. Epub 2022 Jun 13.
BACKGROUND
Opioids are potent analgesics used for the treatment of moderate to severe acute and chronic cancer and non-cancer pain. However, opioid usage may be limited by negative side effects, such as potentially life-threatening respiratory depression.
OBJECTIVES
The aim of our study is to investigate the prevalence of opioid-induced respiratory depression (OIRD) and its predictors at King Abdulaziz Medical City in Jeddah (KAMC-JD).
METHOD
This is a retrospective cross-sectional (chart review) study conducted from January 1, 2016, to December 31, 2020.
RESULTS
A total of 15,753 patients received opioids during admission to KAMC-JD, and only 144 (0.915%) of them received naloxone from January 1, 2016 to December 31, 2020. Only 91 patients (0.57%) developed opioid-induced respiratory depression (OIRD), which was more frequently reported among young and middle-aged adults. OIRD was significantly associated with receiving a daily morphine milligram equivalent (MME) dose of ≥150 MME and with having a low urea concentration at the baseline and at admission under surgery. Also, fentanyl use remained a significant risk factor for OIRD.
CONCLUSION
In conclusion, monitoring patient receiving opioids with a daily MME dose of ≥150 MME, prescribed Fentanyl, low urea concentration at the baseline, and patients' admissions to the surgery department may mitigate the risk of developing OIRD.
背景
阿片类药物是强效镇痛药，用于治疗中度至重度急性和慢性癌症及非癌症疼痛。然而，阿片类药物的使用可能会受到负面副作用的限制，如潜在的危及生命的呼吸抑制。
目的
我们研究的目的是调查吉达阿卜杜勒阿齐兹国王医疗城（KAMC-JD）阿片类药物引起的呼吸抑制（OIRD）的患病率及其预测因素。
方法
这是一项回顾性横断面（病历审查）研究，时间跨度为2016年1月1日至2020年12月31日。
结果
在KAMC-JD住院期间，共有15753名患者接受了阿片类药物治疗，从2016年1月1日至2020年12月31日，其中只有144名（0.915%）接受了纳洛酮治疗。只有91名患者（0.57%）发生了阿片类药物引起的呼吸抑制（OIRD），在中青年成年人中报告更为频繁。OIRD与每日吗啡毫克当量（MME）剂量≥150 MME显著相关，并且与基线时和手术入院时尿素浓度较低有关。此外，使用芬太尼仍然是OIRD的一个重要危险因素。
结论
总之，监测每日MME剂量≥150 MME、使用芬太尼、基线尿素浓度低的阿片类药物使用者以及手术科室的患者入院情况，可能会降低发生OIRD的风险。
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