术前长期使用阿片类药物对桡骨远端手术结果的风险。

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-10-01 Epub Date: 2023-03-22 DOI:10.1177/15589447231160206
William N Newton, Jake A Sossamon, Jonathan R Pire, Dane N Daley
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引用次数: 0

摘要

研究背景本研究旨在确定术前长期使用阿片类药物对桡骨远端骨折切开复位内固定术(ORIF)患者的并发症、再手术率和术后阿片类药物使用的影响:对一家学术医疗中心在 2019 年至 2021 年期间接受桡骨远端骨折切开复位内固定术(ORIF)的 111 名患者进行了回顾性研究,这些患者均由同一位接受过研究员培训的骨科手外科医生治疗。研究分析了患者的人口统计学特征、合并症、围手术期细节、手术并发症以及患者报告的结果指标。SCRIPTS数据库用于获取阿片类药物处方数据:结果:共有 10 名患者(9.01%)被确认为术前长期阿片类药物使用者。这一群体与并发症增加的风险无关。不过,他们在术后 90 天和 180 天继续使用麻醉剂的可能性更大。有药物使用史的患者发生硬件并发症和延长术后疼痛时间的风险更高。此外,这些患者更有可能在术后90天和180天接受麻醉药物治疗,而且术后需要重新配药的次数也更多:结论:术前使用阿片类药物的患者在桡骨远端骨折 ORIF 术后发生手术并发症的风险并不会增加。结论:术前使用阿片类药物的患者不会增加桡骨远端骨折术后出现手术并发症的风险,但会增加术后长期使用阿片类药物的风险。已知有药物使用史的患者发生硬件并发症、疼痛时间延长和术后阿片类药物使用增加的风险更高。外科医生应考虑这些关联,以便在术后更好地管理患者。
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Risks of Chronic Preoperative Opioid Use on Distal Radius Surgery Outcomes.

Background: The purpose of this study was to determine the influence of chronic preoperative opioid use on complications, reoperation rates, and postoperative opioid use among patients undergoing open reduction and internal fixation (ORIF) of distal radius fractures.

Methods: A retrospective review of 111 patients who underwent ORIF of a distal radius fracture from 2019 to 2021 at an academic medical center by the same fellowship-trained orthopedic hand surgeon was conducted. Patient demographics, medical comorbidities, perioperative details, surgical complications, and patient-reported outcome measures were analyzed. The SCRIPTS database was used to obtain opioid prescription data.

Results: A total of 10 patients (9.01%) were identified as preoperative chronic opioid users. This group was not associated with risk of increased complication. However, they were more likely to continue using narcotics at 90 and 180 days postoperatively. Patients with a history of substance use were at an increased risk of hardware complications and prolonged postoperative pain. In addition, these patients were more likely to receive narcotics at 90 and 180 days, and to have more refills postoperatively.

Conclusion: Patients with preoperative opioid use are not at an increased risk of surgical complication following ORIF of distal radius fractures. However, they are at an increased risk of prolonged postoperative opioid use. Patients with a known history of substance use were at an increased risk of hardware complications, prolonged pain, and increased postoperative opioid use. Surgeons should consider these associations to better manage individual patients in the postoperative period.

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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
期刊最新文献
Early and Late Intrinsic Hand Muscle Reinnervation After End-to-Side AIN to Ulnar Motor Nerve Transfer. Generic Volar Locking Plate Use in Distal Radius Fractures: A Prospective Randomized Study to Evaluate Clinical Outcomes and Cost Reduction. Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room. Management Options and Clinical Outcomes After Flexor Tendon Ruptures Following Volar Plating of Distal Radius Fractures. Decreased Complication Rate Using Partially Threaded Compared With Fully Threaded Compression Screws in 4 Corner Arthrodesis: A Retrospective Study.
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