Prescription Opioid Type and the Likelihood of Prolonged Opioid Use After Orthopaedic Surgery.
Prescription Opioid Type and the Likelihood of Prolonged Opioid Use After Orthopaedic Surgery.
复制标题
DOI：
10.5435/jaaos-d-17-00663
复制
发表时间：
2019-05-01
期刊：
影响因子：
--
通讯作者：
Heng M
中科院分区：
文献类型：
--
作者：
Basilico M;Bhashyam AR;Harris MB;Heng M
一种普遍的看法是，一些麻醉性药物与长期使用有更高的联系。我们评估了手术后阿片类药物缺乏的骨科创伤患者最初使用的阿片类药物是否与阿片类药物的长期使用有关。我们研究了17,961名成年阿片类药物天真的患者，他们接受了手术治疗的肌肉骨骼损伤。计算了吗啡毫克当量(MME，一种允许对阿片类药物类型进行比较的标准化剂量单位)的放电处方。伤后超过90天的阿片类药物处方被定义为长期使用。初步分析显示，与氢可酮相比，使用氢吗啡或吗啡出院的患者延长使用时间的可能性更高。然而，当我们调整了MME的排放量时，只有阿片类药物的数量可以预测长期使用(p<；0.001)。此外，MME放电与阿片类药物类型相关(P<；0.01)。持续使用阿片类药物与阿片类药物的释放数量有关，而与阿片类药物的类型无关。这些结果突显了在选择阿片类药物类型和考虑麻醉药品处方数量时计算等效剂量的重要性。
A common belief is that some narcotic medications have a higher association with prolonged use. We assessed if the initial opiate type prescribed to post-operative, opiate-naïve orthopaedic trauma patients was associated with prolonged opioid use. We studied 17,961 adult, opiate-naïve patients treated for an operative musculoskeletal injury. Discharge prescription in morphine milligram equivalents (MME, a standardized dosing unit that allows for comparison across opioid types) was calculated. Opioid prescribing beyond 90 days post-injury was defined as prolonged use. Initial analysis demonstrated a higher likelihood of prolonged use for patients discharged on hydromorphone or morphine versus hydrocodone. However, when we adjusted for discharge MME, only opioid quantity was predictive of prolonged use (p<0.001). In addition, discharge MME was associated with opioid type (p<0.01). Persistent opiate use was associated with discharge opioid quantity, not the opioid type. These results highlight the importance of calculating equivalence doses when selecting opioid types and considering amount of narcotics prescribed.