美沙酮在心脏手术术后疼痛管理中的作用

BJA open Pub Date : 2024-03-22 DOI:10.1016/j.bjao.2024.100270

Jordan N. Edwards , Madeline A. Whitney , Bradford B. Smith , Megan K. Fah , Skye A. Buckner Petty , Omar Durra , Kristen A. Sell-Dottin , Erica Portner , Erica D. Wittwer , Adam J. Milam

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引用次数: 0

摘要

背景这项回顾性研究评估了术中美沙酮与短效阿片类药物相比的疗效和安全性。方法将2018年至2023年在单一医疗系统接受心肺旁路心脏手术的患者（n=11 967）根据术中阿片类药物给药情况分为几组：无美沙酮组（O组）、美沙酮加其他阿片类药物组（M+O组）和仅有美沙酮组（M组）。结果经协变因素调整后，M 组和 M+O 组患者在术后第 7 天前的平均疼痛评分低于 O 组（P<0.01）。与 O 组相比，M 组和 M+O 组在 POD0-POD6 各天的阿片类药物总用量均较低（均为 P<0.001）。O组、M+O组和M组术后首次使用阿片类药物前的中位小时数分别为2.55（四分位数间距[IQR]=1.07-5.12）、6.82（IQR=3.52-12.98）和7.0（IQR=3.82-12.95）。术后并发症的发生率在各组间无差异。

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The role of methadone in cardiac surgery for management of postoperative pain

Background

This retrospective study evaluated the efficacy and safety of intraoperative methadone compared with short-acting opioids.

Methods

Patients undergoing cardiac surgery with cardiopulmonary bypass (n=11 967) from 2018 to 2023 from a single health system were categorised into groups based on intraoperative opioid administration: no methadone (Group O), methadone plus other opioids (Group M+O), and methadone only (Group M).

Results

Patients in Groups M and M+O had lower mean pain scores until postoperative day (POD) 7 compared with Group O after adjusting for covariates (P<0.01). Both Groups M and M+O had lower total opioid administered compared with Group O for all days POD0–POD6 (all P<0.001). The median number of hours until initial postoperative opioid after surgery was 2.55 (inter-quartile range [IQR]=1.07–5.12), 6.82 (IQR=3.52–12.98), and 7.0 (IQR=3.82–12.95) for Group O, Group M+O, and Group M, respectively. The incidence of postoperative complications did not differ between groups.