Tolley James A, Michel Martha A, Sarmiento Elisa J
Section of Pediatric Anesthesia, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA.
Children (Basel). 2022 Dec 24;10(1):37. doi: 10.3390/children10010037.
Anywhere from 11.6% to 20% of pediatric and adolescent patients treated for chronic pain are prescribed opioids, but little is known about these patients. The purpose of this study was to determine the characteristics of patients on chronic opioid therapy (COT) and what therapies had been utilized prior to or in conjunction with COT. The study was a retrospective chart review of all chronic pain patients seen during 2020 with those patients on COT separated for analysis. A total of 346 unique patients were seen of which 257 were female (74.3%). The average age was 15.5 years. A total of 48 patients (13.9%) were identified as being on COT with an average age of 18.1 years. Of these, 23 (47.9%) were male which was significantly more than expected. The most common reason for patients to be receiving COT was palliative (13/48), and the second most common was sickle cell anemia (10/48). Patients on COT were significantly more likely to be male, be older, and to be concurrently prescribed benzodiazepines. Concurrent opioid and benzodiazepine therapy is a risk factor for respiratory depression and overdose. Further investigation into the increased proportion of males and benzodiazepine usage in patients on COT is warranted.
接受慢性疼痛治疗的儿科和青少年患者中，有11.6%至20%的人会被开阿片类药物，但人们对这些患者了解甚少。本研究的目的是确定接受慢性阿片类药物治疗（COT）的患者的特征，以及在COT之前或与COT同时使用过哪些治疗方法。该研究是对2020年期间就诊的所有慢性疼痛患者的病历进行回顾性分析，将接受COT的患者分开进行分析。总共观察了346名患者，其中257名是女性（74.3%）。平均年龄为15.5岁。共有48名患者（13.9%）被确定为接受COT治疗，平均年龄为18.1岁。其中，23名（47.9%）是男性，这一比例明显高于预期。患者接受COT治疗的最常见原因是姑息治疗（13/48），第二常见原因是镰状细胞贫血（10/48）。接受COT治疗的患者更有可能是男性、年龄较大，并且同时被开了苯二氮䓬类药物。阿片类药物和苯二氮䓬类药物同时治疗是呼吸抑制和药物过量的一个危险因素。有必要对接受COT治疗的患者中男性比例增加和苯二氮䓬类药物使用情况进行进一步调查。
