College of Medicine, University of Kentucky, Lexington, KY, USA.
Division of General, Endocrine and Metabolic Surgery, Department of Surgery, University of Kentucky, 800 Rose Street, C-240, Lexington, KY, 40536, USA.
Surg Endosc. 2024 Jun;38(6):3052-3060. doi: 10.1007/s00464-024-10808-9. Epub 2024 Apr 12.
One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription.
VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison.
205 patients were included in the study (average age 53.5 years; 50.7% female). Over 35% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001).
Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified.
在接受腹侧和切口疝修复术（VIHR）的患者中，有二分之一的患者在手术前一年有开具阿片类药物的处方。本研究旨在调查有或无术前阿片类药物处方的患者术后处方增加的风险因素。
回顾了 2013 年至 2017 年的 VIHR 病例。州处方药监测计划数据与患者记录相关联。主要终点是通过出院后第 45 天发放的累积阿片类药物剂量。使用吗啡毫克当量（MME）进行统一比较。
研究纳入了 205 名患者（平均年龄 53.5 岁；50.7%为女性）。超过 35%的患者符合术前使用阿片类药物的标准。术前阿片类药物耐受、浅表伤口感染、当前吸烟状况以及入院后 45 天内任何阿片类药物的发放均是术后阿片类药物使用增加的独立预测因素（p<0.001）。
在入院前 45 天内使用阿片类药物与 VIHR 患者的术后处方增加密切相关，并确定了几个独立的风险因素。
