术前观看教育视频不会影响膝关节镜部分半月板切除术后阿片类药物的使用:一项前瞻性队列研究

Marc G. Lubitz M.D. , Luke Latario M.D. , Oghomwen Ogbeide-Latario B.Sc. , Kevin Hughes M.D. , Stephanie Clegg M.D. , Vadim Molla M.D. , Michael Brown M.D. , Brian Busconi M.D. , Nicola DeAngelis M.D.
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引用次数: 0

摘要

目的确定访问带有教育视频的网站是否会减少接受关节镜半月板部分切除术的患者术后阿片类药物的使用。方法在一家中心接受关节镜半月板部分切除术的入组患者在术前被随机分配到干预组或对照组。干预组患者在接受术后指导时会收到一张卡片,上面附有关于阿片类药物的在线教育视频;对照组患者则没有收到卡片。该在线视频仅有 5 分多钟,内容包括使用阿片类药物的危险性、如何安全处置未使用的阿片类药物以及当地支持联系信息等一般信息。术后 10 至 14 天通过电话收集数据,并使用 GraphPad Prism 9.5.0 版进行分析。患者特征包括年龄、性别、体重指数、过敏症、吸烟、抑郁、酗酒、美国麻醉医师协会等级、慢性阻塞性肺病诊断、高血压、糖尿病、药物滥用、就业状况、工伤赔偿和体育运动参与情况,这些特征与术后阿片类药物使用情况相关。对照组的平均用药量为 3 片,干预组为 2.2 片。这一差异未达到统计学意义。肥胖、吸烟或被诊断患有抑郁症的患者消耗的阿片类药物更多,术后不服用麻醉药的可能性更小。与不参加体育运动的患者相比,参加体育运动的患者平均消耗的阿片类药物总量较少。对具有较高风险因素的患者进行的分组分析表明,对照组和干预组在阿片类药物的平均用量或不使用麻醉药物的可能性方面没有差异。在所有患者中,82 人(49%)术后未使用麻醉药,90% 的患者使用了 8 片或更少。接受关节镜半月板切除术的患者如果肥胖、吸烟、临床情绪低落或不参加体育运动,术后可能会使用更多的麻醉药物。无论是否观看了在线教育视频,半数患者都没有使用麻醉药。
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Access to an Educational Video Preoperatively Has No Effect on Postoperative Opioid Use After Arthroscopic Partial Meniscectomy of the Knee: A Prospective Cohort Study

Purpose

To determine whether access to a website with an educational video would decrease postoperative opioid use in patients undergoing arthroscopic partial meniscectomy.

Methods

Enrolled patients who underwent arthroscopic partial meniscectomy at a single center were randomized to either the intervention or control group prior to surgery. The intervention group received a card with access to an online educational video regarding opioids with their postoperative instructions; the control group did not. The online video was just over 5 minutes long and contained general information about the dangers of opioid use, how to safely dispose of unused opioids, and local support contact information. Data were collected by telephone 10 to 14 days postoperatively and analyzed with GraphPad Prism version 9.5.0. Patient characteristics including age, sex, body mass index, allergies, smoking, depression, alcohol abuse, American Society of Anesthesiologists level, diagnosis of chronic obstructive pulmonary disease, hypertension, diabetes, substance abuse, employment status, workers’ compensation, and sports participation were analyzed and correlated with postoperative opioid use.

Results

A total of 166 patients were included in this study, with 78 in the control group and 88 in the intervention group. Mean number of pills consumed was 3 in the control group and 2.2 in the intervention group. This difference did not reach statistical significance. Patients who were obese, smokers, or diagnosed with depression both consumed more opioids and were less likely to take no narcotics postoperatively. Patients who participated in sports consumed fewer total opioids on average than those who did not. Subgroup analysis of patients with higher risk factors did not show a difference between the control and intervention groups in the average amount of opioid used or the likelihood of using no narcotics. Among all patients, 82 (49%) used no narcotics postoperatively and 90% used 8 or fewer tablets.

Conclusions

Directing patients to an educational website and video is not an effective tool in decreasing opioid consumption. Patients undergoing arthroscopic meniscectomy who are obese, active smokers, and clinically depressed or do not participate in sports are likely to use more postoperative narcotics. Regardless of access to the online educational video, half of patients used no narcotics.

Level of Evidence

Level II, prospective cohort.

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CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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