Int J Dermatol:皮肤科医生的全身性阿片类药物真的用对了吗?

2022-04-02 医路坦克 MedSci原创

皮肤科医生治疗许多以疼痛为主要特征的皮肤病,这项系统的综述旨在综合皮肤科医生使用阿片类药物的现有证据,可能有助于为皮肤科关于阿片类药物处方的建议或指南提供信息。

皮肤科医生治疗许多以疼痛为主要特征的皮肤病。此外,皮肤科医生还会进行许多可能需要使用镇痛剂的手术。尽管皮肤科医生很重要能够很好地控制患者的疼痛,但我们目前正面临阿片类药物的流行。

阿片类药物的处方可能会给患者带来一些短期和长期的不良反应。阿片类药物使用的短期副作用包括便秘、尿滞留、恶心和呕吐3阿片类药物使用和处方的长期副作用包括阿片类药物相关住院率和过量服药率增加,阿片类药物使用障碍的发展,以及处方滥用。目前,估计有8%-12%的使用阿片类药物的患者出现阿片类药物使用障碍。阿片类药物滥用在世界各地都在上升,研究估计21%-29%的患者为慢性疼痛开出阿片类药物滥用阿片类药物。

皮肤科专用的阿片类药物文献大多与程序相关疼痛的治疗有关。2018年,皮肤科医生估计进行了1250万次手术,与2017年相比增加了19%。随着皮肤科手术的增加,确定阿片类药物在术后疼痛控制中的作用是重要的。此外,阿片类药物也用于其他疼痛的皮肤疾病,如化脓性汗腺炎(HS)、皮肤溃疡、蜂窝织炎和脓肿。迫切需要相关研究,以便皮肤科医生能够确定皮肤科全身阿片类药物的使用范围,以便将我们对阿片类药物流行降至最低。

这项系统的综述旨在综合皮肤科医生使用阿片类药物的现有证据,包括手术和皮肤病条件下的阿片类药物处方。这些信息可能有助于为皮肤科关于阿片类药物处方的建议或指南提供信息。

 我们应用了Prisma指南,并系统地回顾了PubMed、EMBASE和Cochrane数据库中1980年至2020年发表的阿片类药物在皮肤科的使用情况的文献。我们确定了24项研究,分析了52,705,201名患者和13,099名皮肤科医生。34%至87.5%的患者在皮肤科手术后接受阿片类药物治疗;然而,许多患者没有使用全部处方,35%-69%的患者没有使用任何处方。顶级阿片类药物处方医生更有可能是莫氏外科医生。

与其他专科相比,皮肤科的阿片类药物处方较低,但患者并未使用其全部处方。阿片类药物处方非手术性皮肤病各不相同;针对这些疾病的发病机制的治疗对于减少阿片类药物的使用是重要的。皮肤科医生应考虑限制阿片类药物处方和使用非麻醉性镇痛药。

文献来源:Pourali SP,  Gutierrez Y,  Jones ME, Are we contributing to the opioid epidemic? A systematic review on systemic opioid use in dermatology.Int J Dermatol 2021 Dec 06; 

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    2022-04-24 ms8000000797564657

    ***

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    2022-04-12 ms3000000740036377

    学习!

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    2022-04-03 lhlxtx
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    2022-04-03 zll0626
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    2022-04-02 医鸣惊人

    认真学习了

    0

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