Opioid guidelines for common dental surgical procedures: a multidisciplinary panel consensus.
Opioid guidelines for common dental surgical procedures: a multidisciplinary panel consensus.
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DOI：
10.1016/j.ijom.2019.09.001
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发表时间：
2020-03
影响因子：
2.4
通讯作者：
Makary MA
中科院分区：
文献类型：
--
作者：
Farooqi OA;Bruhn WE;Lecholop MK;Velasquez-Plata D;Maloney JG;Rizwi S;Templeton RB;Goerig A;Hezkial C;Novince CM;Zieman MT;Lotesto AMN;Makary MA
在外科手术后，每16名服用阿片类药物的患者中就有一人会成为长期使用者。在普通牙科手术后缺乏特定的手术指南导致阿片类药物过度处方问题。我们召集了一个多学科小组，为普通牙科手术后的阿片类药物处方制定共识建议。我们使用三步改进德尔菲法为14种常见牙科手术的门诊阿片类药物处方制定共识建议。这个多机构、多学科的小组代表了七个相关的利益相关者群体（口腔外科医生、牙周病专家、牙髓学专家、普通牙医、普通外科医生、口腔外科住院医生和口腔外科患者）。专家组确定了临床医生应考虑开处方的阿片类药物的最小和最大数量。对于所有14种外科手术，推荐布洛芬作为初始治疗。推荐的阿片类药物最大剂量因手术而异（总中位数= 5片，范围= 0-15片）。14例手术中有6例（43%）建议使用0片阿片类药物，14例手术中有4例（27%）建议使用1 - 10片阿片类药物，14例手术中有4例（27%）建议使用11-15片阿片类药物。特定程序的处方建议可能有助于为临床医生提供指导，并有助于解决阿片类药物过度处方问题。
One in 16 patients prescribed opioids after a surgical procedure will become a long-term user. The lack of procedure-specific guidelines after common dental procedures contributes to the opioid overprescribing problem. We convened a multidisciplinary panel to develop consensus recommendations for opioid prescribing after common dental procedures. We used a three-step modified Delphi method to develop a consensus recommendation for outpatient opioid prescribing for 14 common dental procedures. The multi-institution, multidisciplinary panel represented seven relevant stakeholder groups (oral surgeons, periodontics, endodontics, general dentists, general surgeons, oral surgery residents, and oral surgery patients). The panel determined the minimum and maximum number of opioid tablets a clinician should consider prescribing. For all 14 surgical procedures, ibuprofen was recommended as initial therapy. The maximum number of opioid tablets recommended varied by procedure (overall median = 5 tablets, range = 0–15 tablets). Zero opioid tablets were recommended as the maximum number for six of 14 (43%) procedures, one to 10 opioid tablets was the maximum for four of 14 (27%) procedures, and 11–15 tablets was the maximum for four of 14 (27%) procedures. Procedure-specific prescribing recommendations may help provide guidance to clinicians and help address the opioid overprescribing problem.
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影响因子：
16.9
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