脊髓损伤及阿片类药物的使用

Spinal Cord Injury and Prescribed Opioids for Pain

摘要: 目的：脊髓损伤(SCI)是一种会引起生活质量严重下降的神经系统疾病，影响身心健康及相关的高疼痛发生率。因此，患有SCI的个体可能更有可能接触阿片类药物。此篇文章我们综合已发表的关于急性SCI后和处方阿片类药物用于疼痛的研究结果，综合研究结果确定文献差距，为未来的研究提出建议。方法：我们检索了3个电子书目数据库(PubMed [MEDLINE]、Ovid [MEDLINE]、EMBASE)，查找2014年至2021年发表的文章。数据由2位独立评审员使用电子数据库提取。确定了阿片类药物使用导致慢性SCI的危险因素并进行了差异分析。结果：在范围界定审查中包含的16篇文章中，大多数是在美国进行的(n = 9)。大多数文章缺乏有关收入(87.5%)、民族(87.5%)和种族(75%)的信息。在报告此信息的文章中，处方阿片类药物的使用范围为35%至64% (n = 7篇文章，n = 3675名参与者)。已确定的阿片类药物使用风险因素包括中年、低收入、骨关节炎诊断、既往使用阿片类药物和轻度脊柱损伤。结论：针对本次范围界定审查发现的差距，为未来的研究提出相关建议。

Abstract: Objective: Spinal cord injury (SCI) is a life-altering neurological condition affecting physical and psycho-social functioning and associated high rates of pain. Thus, individuals with SCI may be more likely to be exposed to prescription opioids. A scoping review was conducted to synthesize pub-lished research findings on post-acute SCI and prescription opioid use for pain, identify literature gaps, and propose recommendations for future research. Methods: We searched 3 electronic bibli-ographic databases (PubMed [MEDLINE], Ovid [MEDLINE], EMBASE) for articles published from 2014 to 2021. Data were extracted using an electronic database by 2 independent reviewers. Opi-oid use risk factors for chronic SCI were identified and a gap analysis was performed. Results: Of the 16 articles included in the scoping review, a majority were conducted in the United States (n = 9). Most articles lacked information on income (87.5%), ethnicity (87.5%), and race (75%). Prescrip-tion opioid use ranged from 35% to 64% in articles reporting this information (n = 7 articles, n = 3675 participants). Identified risk factors for opioid use included middle age, lower income, osteo-arthritis diagnosis, prior opioid use, and lower-level spinal injury. Conclusions: To address the gaps identified in this scoping review and make recommendations for future research.