Oral Opioid Use during Vaginal Delivery Hospitalizations.
Oral Opioid Use during Vaginal Delivery Hospitalizations.
复制标题
阴道分娩住院期间口服阿片类药物的使用。
DOI：
10.1055/s-0039-1678566
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发表时间：
2020
影响因子：
2
通讯作者：
Friedman,AlexanderM
中科院分区：
文献类型：
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作者：
Mourad,Mirella;Landau,Ruth;Wright,JasonD;Siddiq,Zainab;Duffy,CassandraR;Kern-Goldberger,AdinaR;D'Alton,MaryE;Friedman,AlexanderM
目的本研究旨在确定阴道分娩住院期间短效阿片类药物的使用情况。研究设计对Perspective数据库进行分析，以评估2006年1月至2015年3月阴道分娩住院期间短效口服阿片类药物的使用模式。建立了评估人口和医院因素作用的未调整和调整模型，以评估阿片类药物的使用。评估了医院一级阿片类药物使用率。阿片类药物滥用或依赖妇女的阿片类药物接受情况是根据阿片类药物使用的总体住院率进行评估的。结果在2006年至2015年的3785396例阴道分娩住院患者中，1720899例（45.5%）女性接受了口服阿片类药物缓解疼痛。在纳入分析的458家医院中，阿片类药物的使用差异显著，三分之一的医院为<38%的患者提供阿片类药物，三分之一为38%至<59%的患者提供阿片类药物，三分之一至≥59%的患者提供阿片类药物。当按阿片类药物总体给药率对医院进行分层时，阿片类药物滥用或依赖的妇女在阿片类药物总体给药率较低的医院接受阿片类药物治疗的可能性较小。不同医院在阴道分娩住院期间阿片类止痛药的使用差异很大，这表明疼痛管理实践的标准化可以减少阿片类药物的使用。
ObjectiveThis study aimed to determine the receipt of short-acting opioid medications during vaginal delivery hospitalizations.Study DesignThe Perspective database was analyzed to evaluate patterns of short-acting oral opioid use during vaginal delivery hospitalizations from January 2006 to March 2015. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating use of opioids. Hospital-level rates of opioid use were evaluated. Opioid receipt among women with opioid abuse or dependence was evaluated based on overall hospital rates of opioid use.ResultsOf 3,785,396 vaginal delivery hospitalizations from 2006 to 2015, 1,720,899 (45.5%) women received an oral opioid for pain relief. Opioid use varied significantly among the 458 hospitals included in the analysis, with one-third of hospitals providing opioids to <38% of patients, one-third to 38 to <59% of patients, and one-third to ≥59% of patients. When hospitals were stratified by overall opioid administration rates, women with opioid abuse or dependence were less likely to be given opioids in hospitals with low overall opioid rates.DiscussionThe use of opioid pain medications during vaginal delivery hospitalizations varied significantly among hospitals, suggesting that standardization of pain management practices could reduce opioid use.