肱骨髁上骨折闭合复位和经皮钉钉治疗后儿童骨科阿片类药物的处方模式。

Amy Birnbaum, Debra A Sala, Pablo Castañeda
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引用次数: 0

摘要

背景:目前儿科人群中处方阿片类药物的使用呈惊人的上升趋势。以往处方类阿片的医疗使用已显示与处方类阿片的非医疗使用相关。为了解决这个问题,机构已经开始研究处方模式,以了解并最终标准化疼痛协议,以减少手术后不必要的止痛药。阿片类药物继续被广泛用于骨科患者术后疼痛控制。因此,本研究调查了一家大型儿科骨科医院联盟在肱骨髁上骨折闭合复位和经皮钉钉治疗后的处方模式。方法:回顾性分析,以便更好地了解该患者群体镇痛药的处方变异性。采用描述性统计和卡方分析对处方模式进行评价。结果:49.6%的患者术后使用麻醉药物。麻醉处方与住院时间和骨折严重程度无差异。此外,有几个记录的处方错误,最常见的是由初级骨科住院医师。结论:小儿肱骨髁上骨折后不同医师的处方模式存在显著差异。了解这些模式并实施更标准化的疼痛控制方法可能有助于打击处方错误。
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Opioid Prescription Patterns in Pediatric Orthopedics Following Closed Reduction and Percutaneous Pinning for Supracondylar Humerus Fractures.

Background: There is currently an alarming upward trend in the use of prescription opioids in the pediatric population. Previous medical use of prescription opioids has shown to correlate to non-medical use of prescription opioids. To combat this, institutions have started to look at prescribing patterns to understand and eventually standardize a pain protocol to reduce unnecessary analgesics after surgery. Opioids continue to be used widely for postoperative pain control in orthopedic patients. Therefore, this study examined the prescription patterns within a large pediatric orthopedic hospital consortium after closed reduction and percutaneous pinning for supracondylar humerus fractures.

Methods: A retrospective analysis was performed in order to understand the prescribing variability in analgesics for this patient population better. Descriptive statistics and chi-squared analysis were used to evaluate for prescribing patterns.

Results: Narcotic medications were prescribed postoperatively to 49.6% of patients. There was no difference in narcotic prescription with length of stay or severity of fracture. Additionally, there were several documented prescribing errors, most commonly by a junior orthopedic resident.

Conclusions: There is significant variability in prescribing patterns among physicians after pediatric supracondylar humerus fractures. Understanding the patterns and implementing a more standardized approach to pain control may help to combat prescribing errors.

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