The first 24 h: opioid administration in people with spinal cord injury and neurologic recovery.
The first 24 h: opioid administration in people with spinal cord injury and neurologic recovery.
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第一个 24 小时：脊髓损伤和神经功能恢复患者服用阿片类药物。
DOI：
10.1038/s41393-020-0483-x
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发表时间：
2020
期刊：
影响因子：
2.2
通讯作者：
Hook,Michelle
中科院分区：
文献类型：
--
作者：
Stampas,Argyrios;Pedroza,Claudia;Bush,JenniferN;Ferguson,AdamR;Kramer,JohnLKipling;Hook,Michelle
研究设计回顾性图表回顾。目的本研究的目的是描述急性SCI患者的阿片类药物给药特征，并检查阿片类药物剂量与（1）从住院到康复出院的运动/功能评分变化，和（2）疼痛，抑郁，脊髓损伤模型系统（SCIMS）的建立从2008年到2011年，SCIMS中包括的患者被链接到国家创伤登记处和电子病历。根据24 h时的总吗啡当量（mg）定义了3个阿片类药物剂量组（低、中和高）。阿片类药物剂量组和功能/运动结果之间的关联进行了评估，以及1年的随访疼痛和QOL surveillance.ResultsIn所有，85/180例患者有完整的用药记录。到24小时，所有患者都接受了阿片类药物。与中剂量组和低剂量组相比，接受较高剂量阿片类药物的患者1年后的疼痛评分较高（疼痛水平分别为5.5 vs. 4 vs. 1，p= 0.018）。与低剂量组相比，高剂量组1年后患抑郁症的风险也高出8倍（OR：8.1，95%CI：1.2-53.7）。在分析的运动评分，我们没有发现阿片类药物的剂量和持续时间injuries.ConclusionsThese初步研究结果表明，更高剂量的阿片类药物在24小时内的损伤与增加疼痛的人与SCI的慢性期。
Study designRetrospective chart review.ObjectivesThe objective of this study was to characterize opioid administration in people with acute SCI and examine the association between opioid dose and (1) changes in motor/functional scores from hospital to rehabilitation discharge, and (2) pain, depression, and quality of life (QOL) scores 1-year post injury.SettingSpinal Cord Injury Model System (SCIMS) inpatient acute rehabilitation facility.MethodsPatients included in the SCIMS from 2008 to 2011 were linked to the National Trauma Registry and the electronic medical record. Three opioid dose groups (low, medium, and high) were defined based on the total morphine equivalence in milligrams at 24 h. The associations between opioid dose groups and functional/motor outcomes were assessed, as well as 1-year follow-up pain and QOL surveys.ResultsIn all, 85/180 patients had complete medication records. By 24 h, all patients had received opioids. Patients receiving higher amounts of opioids had higher pain scores 1 year later compared with medium- and low-dose groups (pain levels 5.5 vs. 4 vs. 1, respectively,p= 0.018). There was also an 8× greater risk of depression 1 year later in the high-dose group compared with the low-dose group (OR: 8.1, 95% CI: 1.2–53.7). In analyses of motor scores, we did not find a significant interaction between opioid dose and duration of injury.ConclusionsThese preliminary findings suggest that higher doses of opioids administered within 24 h of injury are associated with increased pain in the chronic phase of people with SCI.