Appropriate Opioid Use After Spine Surgery: Psychobehavioral Barriers and Patient Knowledge.
Appropriate Opioid Use After Spine Surgery: Psychobehavioral Barriers and Patient Knowledge.
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DOI：
10.1016/j.wneu.2021.03.066
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发表时间：
2021-06
影响因子：
2
通讯作者：
Neuman BJ
中科院分区：
文献类型：
--
作者：
Rahman R;Wallam S;Zhang B;Sachdev R;McNeely EL;Kebaish KM;Riley LH 3rd;Cohen DB;Jain A;Lee SH;Sciubba DM;Skolasky RL;Neuman BJ
确定脊柱患者术后阿片类药物使用的障碍、纳洛酮的舒适度、阿片类药物安全处置的知识以及相关因素。我们在术前对174名脊柱患者进行了心理行为障碍调查，以了解阿片类药物的适当使用、纳洛酮的舒适度以及阿片类药物处置的知识。多变量逻辑回归确定了与障碍和知识相关的因素。α= 0.05。常见的障碍是害怕成瘾（71%）和担心疾病进展（43%）。大多数患者（78%）对非阿片类药物控制疼痛的能力有中性/低信心；大多数人（57%）对使用纳洛酮感到中性或不舒服；大多数人（86%）熟悉安全处置方法。焦虑与害怕分散医生的注意力（aOR: 3.8, 95% CI: 1.1-14）以及知道安全处理方法的几率较低相关（aOR: 0.18; 95% CI: 0.04-0.72）。前一个月阿片类药物的使用与纳洛酮的舒适度相关（aOR 4.9, 95% CI 2.1-12）。受教育程度较高的患者报告害怕分散医生注意力的几率较低（aOR 0.30, 95% CI 0.09-0.97），术后曾使用过阿片类药物的患者担心疾病进展的几率较低（aOR 0.25, 95% CI 0.09-0.63），并且相信能够忍受疼痛（aOR 0.34, 95% CI 0.12-0.95）。许多脊柱患者报告术后阿片类药物使用障碍，纳洛酮中性或不舒服。有些人不熟悉安全处置。相关因素包括焦虑、近期未使用阿片类药物以及术后未使用阿片类药物。4
To identify spine patients’ barriers to appropriate postoperative opioid use, comfort with naloxone, knowledge of safe opioid disposal practices, and associated factors. We preoperatively surveyed 174 spine patients about psychobehavioral barriers to appropriate opioid use, comfort with naloxone, and knowledge about opioid disposal. Multivariable logistic regression identified factors associated with barriers and knowledge. α=0.05. Common barriers were fear of addiction (71%) and concern about disease progression (43%). Most patients (78%) had neutral/low confidence in the ability of non-opioid medications to control pain; most (57%) felt neutral or uncomfortable with using naloxone; and most (86%) were familiar with safe disposal. Anxiety was associated with fear of distracting the physician (aOR 3.8, 95% CI 1.1–14) and with lower odds of knowing safe disposal methods (aOR: 0.18; 95% CI: 0.04–0.72). Opioid use during the preceding month was associated with comfort with naloxone (aOR 4.9, 95% CI 2.1–12). Patients with higher educational level had lower odds of reporting fear of distracting the physician (aOR 0.30, 95% CI 0.09–0.97), and those with previous postoperative opioid use had lower odds of concern about disease progression (aOR 0.25, 95% CI 0.09–0.63) and with a belief in tolerating pain (aOR 0.34, 95% CI 0.12–0.95). Many spine patients report barriers to appropriate postoperative opioid use and are neutral or uncomfortable with naloxone. Some are unfamiliar with safe disposal. Associated factors include anxiety, lack of recent opioid use, and no prior postoperative use. IV
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影响因子：
3
作者：
Diebo, Bassel G.;Lavian, Joshua D.;Paulino, Carl B.
通讯作者：
Paulino, Carl B.
影响因子：
1.1
作者：
Bajwa SJ;Haldar R
通讯作者：
Haldar R
影响因子：
168.9
作者：
Carr, DB;Goudas, LC
通讯作者：
Goudas, LC
DOI：
10.1016/j.jamcollsurg.2017.11.023
发表时间：
2018-03-01
影响因子：
5.2
作者：
Hasak, Jessica M.;Bettlach, Carrie L. Roth;Mackinnon, Susan E.
通讯作者：
Mackinnon, Susan E.
影响因子：
3.1
作者：
Gunnarsdottir, Sigridur;Sigurdardottir, Valgerdur;Klepstad, Pal
通讯作者：
Klepstad, Pal