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膝关节镜检查后阿片类药物的使用。

Opioid Consumption After Knee Arthroscopy.

机构信息

New York Medical College, Valhalla, New York, U.S.A.; Orthopaedic & Neurosurgery Specialists, ONS Foundation for Clinical Research and Education, Greenwich, Connecticut, U.S.A..

Orthopaedic & Neurosurgery Specialists, ONS Foundation for Clinical Research and Education, Greenwich, Connecticut, U.S.A.

出版信息

Arthroscopy. 2021 Mar;37(3):919-923.e10. doi: 10.1016/j.arthro.2020.10.019. Epub 2020 Nov 20.

Abstract

PURPOSE

To prospectively observe opioid consumption in patients undergoing knee arthroscopy and to create an evidence-based guideline for opioid prescription.

METHODS

This prospective multicenter observational study enrolled patients undergoing outpatient knee arthroscopy for meniscal repair, meniscectomy, or chondroplasty. Patients were provided with a pain journal to record postoperative opioid consumption, Numeric Pain Rating Scale (NPRS) pain scores, and Likert scale satisfaction scores for 1 week postoperatively. State databases were reviewed for additional opioid prescriptions.

RESULTS

One hundred patients were included in this study. Patients were prescribed a median of 5 pills (37.5 oral morphine equivalent [OME]). Median postoperative opioid consumption was 0 pills, with a mean of 0.6 pills (4.4 OME), and 74% of patients did not consume any opioid medication postoperatively. All patients consumed ≤5 pills (37.5 OME), and no patient required a refill. Patients reported a mean daily NPRS value of 1.9 out of 10 and a mean Likert score of 4.4 out of 5.

CONCLUSION

We found that current opioid prescribing habits exceed the need for postoperative pain management. Overall, all patients consumed ≤5 opioid pills, and 92% of patients discontinued opioids by the second postoperative day. In spite of the low prescription quantity, patients reported high satisfaction rates and low NPRS pain scores and required no refills. Therefore, we recommend that patients undergoing knee arthroscopy are prescribed no more than 5 oxycodone 5-mg pills.

LEVEL OF EVIDENCE

II, prospective prognostic cohort investigation.

摘要

目的

前瞻性观察膝关节镜检查患者的阿片类药物消耗情况,并制定基于证据的阿片类药物处方指南。

方法

这项前瞻性多中心观察性研究纳入了接受门诊膝关节镜检查的半月板修复、半月板切除术或软骨成形术患者。患者被提供疼痛日记,以记录术后阿片类药物消耗、数字疼痛评分量表(NPRS)疼痛评分和术后 1 周的满意度评分。还审查了州数据库以获取其他阿片类药物处方。

结果

本研究纳入了 100 例患者。患者被开具了中位数为 5 片(37.5 口服吗啡当量 [OME])的药物。术后中位阿片类药物消耗为 0 片,平均为 0.6 片(4.4 OME),74%的患者术后未服用任何阿片类药物。所有患者均消耗≤5 片(37.5 OME),且无患者需要续方。患者报告的平均每日 NPRS 值为 10 分中的 1.9 分,平均满意度评分为 5 分中的 4.4 分。

结论

我们发现当前的阿片类药物开具习惯超过了术后疼痛管理的需求。总体而言,所有患者均消耗≤5 片阿片类药物,92%的患者在术后第 2 天停止使用阿片类药物。尽管处方数量较低,但患者报告的满意度较高,NPRS 疼痛评分较低,且无需续方。因此,我们建议膝关节镜检查患者开具不超过 5 片羟考酮 5mg 片剂。

证据水平

II 级,前瞻性预后队列研究。

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