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一项评估三级医院围手术期镇痛药处方模式的观察性研究。

An observational study to evaluate the prescription pattern of analgesics used in the perioperative period in a tertiary care hospital.

作者信息

Joshi Shirish, Shetty Yashashri, Panchal Roshni, Patankar Panini, Salgaonkar Sweta, Rawat Rishabh, Natu Anuya

机构信息

Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Department of Anaesthesiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.

出版信息

Perspect Clin Res. 2021 Jul-Sep;12(3):165-170. doi: 10.4103/picr.PICR_87_19. Epub 2020 May 7.

Abstract

BACKGROUND AND AIMS

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. There are limited observational prescription pattern studies of analgesics in perioperative period in tertiary care hospitals for which this study was carried out in orthopedic, general surgery, and plastic surgery departments. The primary aim was to study the prescription pattern of analgesics in the perioperative period with the secondary aim to study the specific use of opioids and pain relief using the Visual Analog Scale (VAS).

METHODS

A total of 250, 250, and 100 patients were taken from orthopedic, general surgery, and plastic surgery departments, respectively. The analgesics commonly used in preoperative, intraoperative, and postoperative period were observed. The use of opioids in the perioperative period, the number of fixed drug combinations used, the number of generic drug prescription, and pain relief postoperatively were also observed. The analysis was done using descriptive statistics.

RESULTS

Total analgesics prescribed were 1168, 117, and 369 in orthopedic, general surgery, and plastic surgery departments, respectively, and were maximum in the intraoperative period. Most commonly used analgesic in the preoperative and postoperative period was paracetamol and that in intraoperative period was fentanyl. Nonsteroidal anti-inflammatory drugs (NSAIDs) were mainly prescribed by the general surgery department in postoperative period. The amount of pain in postoperative period after treatment with analgesics was mild to moderate as per the VAS.

CONCLUSION

This study revealed that in preoperative and postoperative period, the most common analgesic used is paracetamol. In the intraoperative period, maximum patients received fentanyl. Diclofenac is an established NSAID used in the management of acute and chronic pain states. In our study, we found that the usage of paracetamol was more than NSAIDs and the usage of opioid was maximum during intraoperative period.

摘要

背景与目的

疼痛是一种与实际的或潜在的组织损伤相关的不愉快的感觉和情感体验,或者是用此类损伤来描述的体验。在三级医疗机构中,围手术期镇痛药的观察性处方模式研究有限,本研究在骨科、普通外科和整形外科开展。主要目的是研究围手术期镇痛药的处方模式,次要目的是研究阿片类药物的具体使用情况以及使用视觉模拟评分法(VAS)评估疼痛缓解情况。

方法

分别从骨科、普通外科和整形外科选取250例、250例和100例患者。观察术前、术中和术后常用的镇痛药。还观察了围手术期阿片类药物的使用情况、固定药物组合的使用数量、通用名药物处方的数量以及术后的疼痛缓解情况。采用描述性统计进行分析。

结果

骨科、普通外科和整形外科分别开具的镇痛药总量为1168、117和369,术中开具量最多。术前和术后最常用的镇痛药是对乙酰氨基酚,术中是芬太尼。非甾体抗炎药(NSAIDs)主要由普通外科在术后开具。根据VAS评估,镇痛药治疗后术后疼痛程度为轻度至中度。

结论

本研究表明,术前和术后最常用的镇痛药是对乙酰氨基酚。术中,大多数患者使用芬太尼。双氯芬酸是一种用于治疗急性和慢性疼痛状态的既定NSAIDs。在我们的研究中,我们发现对乙酰氨基酚的使用量超过NSAIDs,且阿片类药物在术中的使用量最大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/073c/8323566/8f45289186b3/PCR-12-165-g001.jpg

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