Leppert W, Luczak J, Gorzelińska L, Kozikowska J
Klinika Opieki Paliatywnej, Anestezjologii i Intensywnej Terapii Onkologicznej, Katedra Onkologii Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu.
Przegl Lek. 2000;57(1):59-64.
Transdermal Fentanyl (TF, Durogesic) is a strong opioid analgesic which is used in the treatment of cancer pain. In this article we described basic properties and dosing guidelines for TF and our own experience with use of Durogesic in the treatment of cancer pain. In this open study TF was administered in 16 pts aged of 30-88 (mean 62 +/- 17) years with advanced cancer who suffered from strong cancer pain and who had previously been treated with morphine (11 pts), buprenorphine (1 pt), tramadol (2 pts) and non-opioid analgesics (2 pts). Analgesic efficacy and side-effects of TF were appraised. The time of the treatment was 7-235 (mean 77 +/- 58) days, the dose range 25-600 (mean 129 +/- 117) micrograms/h. The mean initial dose of Durogesic was 94 +/- 99 micrograms/h and the final dose of fentanyl patch was 156 +/- 149 micrograms/h. Good analgesic effect was achieved in 11 pts (69%), partial effect in 2 pts (12%), unsatisfactory analgesia in 3 pts (19%). The treatment was well tolerated and the most frequent adverse reactions were constipation in 10 pts (63%) and drowsiness in 4 pts (25%). During the therapy with TF we didn't encounter serious side-effects which would cause cessation of the treatment. Results of our study confirmed that TF was an effective analgesic most commonly used in pts with stable nociceptive pain especially when opioid analgesics could not be administered orally.
透皮芬太尼(TF,多瑞吉)是一种强效阿片类镇痛药,用于治疗癌痛。在本文中,我们描述了TF的基本特性和给药指南,以及我们使用多瑞吉治疗癌痛的经验。在这项开放性研究中,对16例年龄在30 - 88岁(平均62±17岁)的晚期癌症患者给予TF,这些患者患有重度癌痛,之前曾接受过吗啡治疗(11例)、丁丙诺啡治疗(1例)、曲马多治疗(2例)和非阿片类镇痛药治疗(2例)。评估了TF的镇痛效果和副作用。治疗时间为7 - 235天(平均77±58天),剂量范围为25 - 600微克/小时(平均129±117微克/小时)。多瑞吉的平均初始剂量为94±99微克/小时,芬太尼透皮贴剂的最终剂量为156±149微克/小时。11例患者(69%)获得了良好的镇痛效果,2例患者(12%)部分有效,3例患者(19%)镇痛效果不满意。治疗耐受性良好,最常见的不良反应是10例患者(63%)出现便秘,4例患者(25%)出现嗜睡。在TF治疗期间,我们未遇到会导致治疗中断的严重副作用。我们的研究结果证实,TF是一种有效的镇痛药,最常用于患有稳定伤害性疼痛的患者,尤其是在无法口服阿片类镇痛药时。