Patterns of Opioid Prescription and Use After Cesarean Delivery
Patterns of Opioid Prescription and Use After Cesarean Delivery
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DOI：
10.1097/aog.0000000000002093
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发表时间：
2017-07-01
影响因子：
7.2
通讯作者：
Leffert, Lisa R.
中科院分区：
文献类型：
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作者：
Bateman, Brian T.;Cole, Naida M.;Leffert, Lisa R.
目的：探讨剖宫产术后出院后阿片类镇痛药的处方用量及使用情况。方法：我们于2014年9月至2016年3月在美国6个学术医疗中心进行调查。剖宫产的妇女在出院后2周通过电话联系，并参加了关于出院时收到的阿片类药物处方和在家时口服阿片类药物摄入量的结构化访谈。结果：共有720名女性入组；其中，615人（85.4%）服用了阿片类药物处方。分配阿片类药物的中位数为40片（四分位数范围为30-40），消耗阿片类药物的中位数为20片（四分位数范围为8-30），剩余阿片类药物的中位数为15片（四分位数范围为3-26）。在那些有剩余阿片类药物的人中，95.3%的人在采访时没有处理掉多余的药物。大剂量的片剂与消耗量之间存在关联，这与患者的特征无关。分配的阿片类药物的数量与患者满意度、疼痛控制或重新处方阿片类药物的需要无关。结论：剖宫产后开具的阿片类药物处方量普遍大大超过消耗量，导致大量阿片类药物残留。较低的阿片类药物处方与较低的消耗量相关，而不会伴随疼痛评分或满意度的增加。
OBJECTIVE: To define the amount of opioid analgesics prescribed and consumed after discharge after cesarean delivery.METHODS: We conducted a survey at six academic medical centers in the United States from September 2014 to March 2016. Women who had undergone a cesarean delivery were contacted by phone 2 weeks after discharge and participated in a structured interview about the opioid prescription they received on discharge and their oral opioid intake while at home.RESULTS: A total of 720 women were enrolled; of these, 615 (85.4%) filled an opioid prescription. The median number of dispensed opioid tablets was 40 (interquartile range 30-40), the median number consumed was 20 (interquartile range 8-30), and leftover was 15 (interquartile range 3-26). Of those with leftover opioids, 95.3% had not disposed of the excess medication at the time of the interview. There was an association between a larger number of tablets dispensed and the number consumed independent of patient characteristics. The amount of opioids dispensed did not correlate with patient satisfaction, pain control, or the need to refill the opioid prescription.CONCLUSION: The amount of opioid prescribed after cesarean delivery generally exceeds the amount consumed by a significant margin, leading to substantial amounts of leftover opioid medication. Lower opioid prescription correlates with lower consumption without a concomitant increase in pain scores or satisfaction.