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Variation in postoperative non-steroidal anti-inflammatory analgesic use after colorectal surgery: a database analysis

机译:大肠手术后术后非甾体类抗炎镇痛药使用的变化:数据库分析

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Background Non-steroid anti-inflammatory drugs (NSAIDs) have been proposed as part of a multimodal postoperative analgesia in patients operated for colorectal cancer. However, whether these drugs are prescribed and taken by the patients have not been evaluated. The aim of this study was to quantify the postoperative use of NSAIDs in these patients. Methods Data from patients operated for colorectal cancer between January 1, 2006 and December 31, 2009 were collected from the Danish Colorectal Cancer Group’s (DCCG) prospective database. From the electronically registered medical records, data for the use of the two NSAIDs diclofenac and ibuprofen were recorded. The data from six colorectal departments in eastern Denmark were compared. Results Of the 2,754 patients analyzed overall, 40.6% received NSAIDs as part of their analgesic treatment. The percentage of the patients receiving NSAIDs, receiving a pre-defined dosage as a minimum and receiving NSAIDs as p.r.n. medication, and the type of NSAID were significantly different both between department and within departments. The median dose of ibuprofen and diclofenac were 1200?mg (400–2,400?mg) and 100?mg (50–200?mg), respectively. Conclusions The large variation between and within the departments points to an inconsistency in the use of multimodal post-operative pain treatments. This may be a result of insufficient evidence on procedure specific pain treatments and possibly a lack of compliance to existing guidelines. High-quality large-scale studies are warranted to form the basis for guidelines for postoperative analgesic treatment.
机译:背景技术已提出非类固醇抗炎药(NSAID)作为大肠癌手术患者多模式术后镇痛的一部分。但是,这些药物是否由患者处方和服用尚未得到评估。这项研究的目的是量化NSAIDs在这些患者中的术后使用。方法从丹麦结直肠癌组织(DCCG)的前瞻性数据库中收集2006年1月1日至2009年12月31日期间进行结直肠癌手术的患者的数据。从电子注册的医疗记录中,记录了使用两种非甾体抗炎药双氯芬酸和布洛芬的数据。比较了丹麦东部六个结直肠部门的数据。结果在总共分析的2,754例患者中,有40.6%的患者接受了NSAIDs作为镇痛治疗的一部分。接受非甾体抗炎药,接受预定剂量的最低剂量和接受非甾体抗炎药的患者百分比。部门之间和部门内部的药物,NSAID类型明显不同。布洛芬和双氯芬酸的中位剂量分别为1200?mg(400–2,400?mg)和100?mg(50–200?mg)。结论科室之间和科室之间的差异很大,表明在多模式术后疼痛治疗中使用不一致。这可能是由于缺乏针对特定过程的疼痛治疗的证据,也可能是由于缺乏对现有准则的遵守。高质量的大规模研究应作为术后镇痛治疗指南的基础。

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