The Personalized Pain Program: A New Transitional Perioperative Pain Care Delivery Model to Improve Surgical Recovery and Address the Opioid Crisis.
The Personalized Pain Program: A New Transitional Perioperative Pain Care Delivery Model to Improve Surgical Recovery and Address the Opioid Crisis.
复制标题
个性化疼痛计划：一种新的过渡性围手术期疼痛护理提供模式，以改善手术康复并解决阿片类药物危机。
DOI：
10.1097/qmh.0000000000000450
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发表时间：
2024
影响因子：
1.2
通讯作者：
Xie,Anping
中科院分区：
文献类型：
--
作者：
Speed,TraciJ;Hanna,MarieN;Xie,Anping
阿片类药物具有成瘾性，长期使用阿片类药物会对个别患者和更广泛的公共卫生产生负面影响。1 2020年，8万多人死于阿片类药物过量。减少对阿片类药物治疗疼痛的依赖仍然是一项公共卫生挑战。根据美国国家卫生统计中心的数据，2020年，美国开出了超过1.42亿张阿片类药物处方。手术是阿片类药物处方的主要原因：美国每年进行超过1亿例外科手术，80%的外科手术导致术后阿片类药物处方。虽然阿片类药物可有效治疗急性疼痛，但从术前到术后过渡期间沟通不良以及术后阿片类药物处方做法的广泛差异增加了阿片类药物使用时间延长和升级的风险，并降低了护理质量。慢性疼痛和既往阿片类药物使用是手术后阿片类药物长期使用的可靠预测因素，无论手术类型如何。3,4一个良好协调和有效整合的卫生保健系统可以引导这些术前阿片类药物治疗先前存在的疼痛的患者到适当的多学科专家那里，他们可以管理围手术期疼痛并优化术后恢复。
Opioids are addictive, and prolonged opioid use has negative consequences for individual patients and public health more broadly. 1 In 2020, more than 80 000 deaths were attributed to an opioid-related overdose. Reducing the reliance on opioids for pain management remains a public health challenge. According to the National Center for Health Statistics, in 2020, more than 142 million opioid prescriptions were dispensed in the United States. Surgery is a leading cause of opioid prescribing: more than 100 million surgical procedures are performed annually in the United States, and 80% of surgical procedures result in a postoperative opioid prescription. While opioids effectively treat acute pain, poor communication across transitions from the pre-to postoperative period and wide variability in opioid prescribing practices postoperatively increase the risk of prolonged and escalated opioid use and reduce quality of care. 2 Chronic pain and preexisting opioid use are robust predictors of prolonged opioid use after surgery, regardless of the type of procedure. 3, 4 A well-coordinated and effectively integrated health care system can shepherd these patients on presurgical opioids for preexisting pain to the appropriate multidisciplinary specialists who can manage perioperative pain and optimize postoperative recovery.