A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery
A Prospective Randomized Study Analyzing Preoperative Opioid Counseling in Pain Management After Carpal Tunnel Release Surgery
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DOI：
10.1016/j.jhsa.2017.07.003
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发表时间：
2017-10-01
影响因子：
1.9
通讯作者：
Ilyas, Asif M.
中科院分区：
文献类型：
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作者：
Alter, Todd H.;Ilyas, Asif M.
目的 处方阿片类药物滥用在美国已变得越来越普遍。已提出术前阿片类药物咨询以减少术后阿片类药物的消耗。本研究旨在评估术前阿片类药物咨询对腕管松解术（CTR）术后患者疼痛体验和阿片类药物消耗量的影响。方法对计划接受CTR手术的连续患者进行前瞻性比较。患者被随机分配接受正式的术前阿片类药物咨询或不接受咨询。所有手术均采用相同的小型开放式CTR手术技术进行，术后服用相同数量的阿片类药物。记录每日阿片类药物的服用量、疼痛程度和任何不良反应。 结果 在手术当天和手术后第一天，接受咨询的患者报告服用的阿片类药物处方量明显少于未咨询组的患者，而疼痛水平体验没有显着差异。此外，接受咨询的患者报告在研究过程中服用的止痛药总量明显低于未接受咨询的患者。两组均未发现重大不良反应。结论发现术前阿片类药物咨询可导致术后阿片类药物总体消耗量显着减少。版权所有 (C) 2017 美国手外科学会。版权所有。
Purpose Prescription opioid misuse has become increasingly prevalent in the United States. Preoperative opioid counseling has been proposed to decrease opioid consumption after surgery. This study aimed to evaluate the effect of preoperative opioid counseling on patients' pain experience and opioid consumption after carpal tunnel release (CTR) surgery.Methods A prospective comparison of consecutive patients scheduled to undergo CTR surgery was conducted. Patients were randomized to receive either formal preoperative opioid counseling or no counseling. All operations were performed with the same mini-open CTR surgical technique, and the same number of opioids were prescribed after surgery. Daily opioid pill consumption, pain levels, and any adverse reactions were recorded.Results During the day of surgery and the first day following surgery, patients in the group with counseling reported significantly fewer prescribed opioid pills consumed compared with patients in the group without counseling, while experiencing no significant difference in pain level experience. In addition, patients in the group with counseling reported a significantly lower number of total pain pills consumed over the course of the study than the group without counseling. No major adverse reactions were noted in either group.Conclusions Preoperative opioid counseling was found to result in a significant decrease in overall opioid consumption after surgery. Copyright (C) 2017 by the American Society for Surgery of the Hand. All rights reserved.