骨科术后中重度疼痛患者镇痛药物应用分析

Analysis of analgesic drugs in patients with moderate to severe postoperative pain in orthopedic department

目的:调查某三甲医院骨科特定患者术后镇痛药物使用情况,为合理用药和优化术后镇痛方案提供参考和依据。方法:采用回顾性分析方法,调取2020年8月–2021年6月骨科特定手术患者临床用药资料,计算镇痛药物的用药频度(DDDs)和限定日费用(DDC),对药物使用情况和合理性进行统计和分析。结果:骨科术后镇痛药物DDDs排名前3位依次是帕瑞昔布钠注射液、美洛昔康片和氟比洛芬酯注射液,44.91%的患者术后使用了多模式镇痛,最常见的给药途径为静脉患者自控镇痛,主要药物为非甾体抗炎药(NSAIDs),常联合阿片类和曲马多,对乙酰氨基酚和局麻药使用率较低。NSAIDs是出现不合理用药问题最多的药物品种,主要问题为多种NSAIDs联用、超适应证和超疗程。结论:骨科应采取科学用药管理措施,优化术后疼痛药物治疗方案,提高用药合理性。

Objective:To investigate the use of analgesic drugs for postoperative pain in orthopedic department of a class A tertiary hospital,and provide references for rational drug use and optimization of postoperative analgesic plan.Methods:Data of the patients undergoing specific orthopedic surgery from August 2020 to June 2021 in a hospital were retrospectively collected,based on which the defined daily doses(DDDs)and defined daily dose cost(DDC)were calculated,and the application and rationality of drug were statistically analyzed.Results:The top 3 drugs ranked by DDDs were parecoxib sodium injection,meloxicam tablets and flurbiprofen axetil injection.44.91%of the patients used multimodal analgesia after operation,in which the most common route was patient-controlled intravenous analgesia,the main drugs were nonsteroidal anti-inflammatory drugs(NSAIDs)often combined with opioid and tramadol.Acetaminophen and local anesthetic were less used.NSAIDs was the drug class with the most unreasonable use,including inappropriate combination medication,off-label use,and over course of treatment.Conclusion:Orthopedic department should take scientific drug management measures to optimize the analgesic regimen for postoperative pain and improve the rationality of medication.