Staats P S
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Oncology (Williston Park). 1999 May;13(5 Suppl 2):58-62.
Neuraxial infusion therapy is an excellent option for selected patients with severe pain. Both epidural and intrathecal systems can be effective for multiple pains and are titratable, nondestructive, and very safe. Intraspinal therapy requires low opioid doses, has no motor, sensory, or sympathetic effects, and may have a lower side-effect liability than systemic therapy. Although most oncologists do not refer patients for intrathecal therapy, a recent study indicated that more oncologists would if they knew more about the therapy and if patients requested it. When permanent systems are used, close follow-up is essential. To obtain the maximum benefit from intraspinal therapy, pain management physicians and oncologists must communicate with each other and work together as partners.
神经轴内输注疗法对于某些患有严重疼痛的患者来说是一个很好的选择。硬膜外和鞘内系统对多种疼痛都可能有效，且可滴定、无创、非常安全。脊髓内治疗所需的阿片类药物剂量较低，没有运动、感觉或交感神经效应，并且可能比全身治疗的副作用风险更低。尽管大多数肿瘤学家不会将患者转介接受鞘内治疗，但最近一项研究表明，如果他们对该治疗了解更多且患者提出要求，更多肿瘤学家会这样做。当使用永久性系统时，密切随访至关重要。为了从脊髓内治疗中获得最大益处，疼痛管理医生和肿瘤学家必须相互沟通并作为合作伙伴共同努力。
