Impact of a multidisciplinary multimodal opioid minimization initiative in kidney transplant recipients.
Impact of a multidisciplinary multimodal opioid minimization initiative in kidney transplant recipients.
复制标题
多学科多模式阿片类药物最小化倡议对肾移植受者的影响。
DOI：
10.1111/ctr.14006
复制
发表时间：
2020
影响因子：
2.1
通讯作者：
Fleming,JamesN
中科院分区：
文献类型：
--
作者：
Rohan,VinayakS;Taber,DavidJ;Patel,Neha;Perez,Caroline;Pilch,Nicole;Parks,Sara;Bolin,Eric;Nadig,SatishN;Baliga,PrabhakarK;Fleming,JamesN
肾移植后阿片类药物的使用已被证明是慢性阿片类药物使用的一个风险因素，这会导致死亡风险增加。本研究的目的是评估多模式疼痛方案和教育质量改进计划在实施2个月后对肾移植后阿片类药物使用的早期影响。这是一项关于术后阿片类药物使用的回顾性、单中心分析，比较了接受阿片类药物教育和多模式疼痛方案(术前TAP/QL阻滞剂、预定APAP和加巴喷丁)的患者与历史对照组的平均每日吗啡毫克当量(MME)。尽管在移植前阿片类药物暴露方面没有差异，但多模式止痛方案队列中每日和总体住院患者的阿片类药物使用量显著减少(38.6vs8.0 MME/day；P<；2.001)；多模式止痛方案队列中5%的患者出院时使用阿片类药物处方，而对照组的这一比例为96%(P<；2.001)。我们的早期结果表明，多模式疼痛方案可以有效和显著地减少肾移植受者短期阿片类药物的使用。
Opioid use after kidney transplant has been shown to be a risk factor for chronic opioid use, which leads to an increased risk of mortality. The purpose of this study was to evaluate the early impact of a multimodal pain regimen and education quality improvement program on opioid use after kidney transplant 2 months after implementation. This was a retrospective, single‐center analysis of post‐operative opioid use, comparing the average daily Morphine milligram equivalents (MME) of the patients who received education on opioids and a multimodal pain regimen (preoperative TAP/QL block, scheduled APAP and gabapentin) compared to a historical control group. Despite having no differences in pre‐transplant opioid exposure, daily and overall inpatient opioid utilization was significantly reduced in the multimodal pain protocol cohort (38.6 vs 8.0 MME/day;P< .001); 5% of patients in the multimodal pain protocol cohort were discharged with an opioid prescription, compared to 96% of controls (P< .001). Our early results demonstrate that a multimodal pain protocol can effectively and dramatically reduce short‐term opioid utilization in kidney transplant recipients.