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首页> 外文期刊>Journal of opioid management >Developing opioid prescribing recommendations in the postoperative orthopedic setting
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Developing opioid prescribing recommendations in the postoperative orthopedic setting

机译：在术后骨科环境中制定阿片类药物的建议

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Background: The use of opioid analgesics in the United States has increased nearly fourfold since 1999 resulting in a similar increase in opioid-related overdose deaths. Although the Centers for Disease Control published guidelines for prescribing chronic opioids, there is a lack of guidance for prescribing postoperative opioids. Objective: To offer an evidence-based approach to prescribing opioids for postoperative pain management in the orthopedic setting. Methods: A narrative review was performed of studies evaluating and quantifying opioid use in orthopedic patients in the postoperative setting, as well as studies analyzing patient satisfaction and perception with regards to opioid use. Results: Studies show that postoperative pain may not be the largest contributing factor to developing an opioid use disorder, but rather patient factors such as tobacco and substance use disorder, mental health disorders, anxiety, mood disorders, pre-existing chronic pain, and recent opioid use may play a role. The review also found that most patients do not utilize significant portions of prescribed opioids and most do not require a refill. This trend leaves patients with thousands of unused pills, which are either retained, shared, or diverted. Although there is no guideline for prescribing opioids postoperatively, data suggest that clinicians can prescribe smaller dosages and fewer quantities of opioids initially. There are also non-opioid strategies that can be employed to reduce opioid consumption. Conclusion: There is a need for more high quality research to be conducted to standardize postoperative opioid prescribing patterns and create best practice guidelines to guide clinicians. Orthopedic practices should consider creating institutional guidelines to reduce the amount of opioids prescribed.
机译：背景：自1999年以来，在美国阿片类镇痛药的使用增加了几乎四倍，导致阿片类药物相关的过量死亡同样增加。虽然疾病控制的中心公布了规定慢性阿片类药物的指导方针，但缺乏术后阿片类药物缺乏指导。目的：提供基于证据的术语术语止痛症术后疼痛管理方法。方法：对术后设定骨科患者的研究和定量阿片类药物的研究进行了叙事审查，以及分析患者满意度和对阿片类药物的认识的研究。结果表明，术后疼痛可能不是开发阿片类药物使用障碍的最大贡献因素，而是烟草和物质使用障碍，心理健康障碍，焦虑，情绪障碍，预先存在的慢性疼痛，以及最近的患者因素阿片类药物可以发挥作用。审查还发现，大多数患者不利用规定的阿片类药物的重要部分，并且大多数不需要补充。这种趋势使患者留有成千上万未使用的药片，其保留，共享或转移。虽然术后没有指导阿片类药物，但数据表明，临床医生最初可以规定较小的剂量和数量的阿片类药物。还有非阿片类药策略，可用于降低阿片类药物消费。结论：需要进行更高质量的研究，以规范术后阿片类药物规定模式，并创造最佳实践指南来指导临床医生。矫形实践应考虑制定机构指导方针，以减少规定的阿片类药物。

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