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剖宫产术后患者特征与阿片类药物消耗量的关联:一项单中心回顾性研究。

Association of patient characteristics with postoperative opioid consumption following cesarean delivery: a single center retrospective study.

作者信息

Wagner Andrea, Birkholz Christopher, Stacey Joanna K, Hofkamp Michael P

机构信息

Department of Obstetrics and Gynecology, Baylor Scott & White Medical Center - Temple, Temple, Texas, USA.

Department of Anesthesiology, Baylor Scott & White Medical Center - Temple, Temple, Texas, USA.

出版信息

Proc (Bayl Univ Med Cent). 2024 Aug 14;37(6):903-907. doi: 10.1080/08998280.2024.2389757. eCollection 2024.

Abstract

BACKGROUND

The primary aim of our study was to determine which patient characteristics were associated with opioid consumption following cesarean delivery.

METHODS

The Baylor Scott & White Research Institute institutional review board approved this study (024-178). Patients who underwent cesarean delivery at Baylor Scott & White Medical Center - Temple with single injection or combined spinal epidural anesthesia in 2023 were eligible for inclusion. We examined the medical records of 300 patients, calculated the 24-hour opioid consumption for each, and compared the top third to the low group in a bivariate analysis and then performed a multivariate logistic regression.

RESULTS

One hundred thirty-one patients had no opioid consumption in the first 24 postoperative hours, and 100 patients had a morphine milligram consumption of 30 to 117.5 mg. A multivariate logistic regression determined that patients in the higher opioid consumption cohort were more likely to have received combined spinal epidural anesthesia (odds ratio 2.079; 95% confidence interval 1.149, 3.762;  = 0.02) and administration of intravenous dexmedetomidine in the intraoperative period (odds ratio 2.542; 95% confidence interval 1.038, 6.224;  = 0.04).

CONCLUSION

Intraoperative administration of intravenous dexmedetomidine and combined spinal epidural anesthesia was associated with increased postoperative opioid consumption following cesarean delivery.

摘要

背景

我们研究的主要目的是确定剖宫产术后哪些患者特征与阿片类药物的使用有关。

方法

贝勒·斯科特与怀特研究所机构审查委员会批准了这项研究(024 - 178)。2023年在贝勒·斯科特与怀特医疗中心 - 坦普尔接受单次注射或腰麻 - 硬膜外联合麻醉剖宫产的患者符合纳入条件。我们检查了300例患者的病历,计算了每位患者24小时的阿片类药物使用量,并在双变量分析中将前三分位数与低分组进行比较,然后进行多因素逻辑回归分析。

结果

131例患者术后24小时内未使用阿片类药物,100例患者吗啡使用量为30至117.5毫克。多因素逻辑回归分析确定,阿片类药物使用量较高的队列中的患者更有可能接受了腰麻 - 硬膜外联合麻醉(比值比2.079;95%置信区间1.149,3.762;P = 0.02)以及术中静脉注射右美托咪定(比值比2.542;95%置信区间1.038,6.224;P = 0.04)。

结论

剖宫产术后,术中静脉注射右美托咪定和腰麻 - 硬膜外联合麻醉与术后阿片类药物使用量增加有关。

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Opioid prescribing patterns among postpartum women.产后妇女阿片类药物处方模式。
Am J Obstet Gynecol. 2018 Jul;219(1):103.e1-103.e8. doi: 10.1016/j.ajog.2018.04.003. Epub 2018 Apr 7.

本文引用的文献

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Combined spinal-epidural versus spinal anaesthesia for caesarean section.剖宫产联合脊髓-硬膜外麻醉与脊髓麻醉的比较
Cochrane Database Syst Rev. 2019 Oct 10;10(10):CD008100. doi: 10.1002/14651858.CD008100.pub2.

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