Theodoridis T, Waap I, Schwalen S, Krämer J
Orthopädische Universitätsklinik, St.-Josef-Hospital/Orthopädie, Bochum.
Z Orthop Ihre Grenzgeb. 2003 Mar-Apr;141(2):217-22. doi: 10.1055/s-2003-38651.
Efficacy and tolerability of analgesic treatment with fentanyl-TTS (Durogesic) for pain caused by arthrosis was investigated.
Treatment with fentanyl-TTS was started for the first time in patients with severe pain caused by coxarthrosis and/or gonarthrosis and was prospectively documented for 30 days. Pain was assessed by the patient with an 11-step numerical analogue scale and by the physician with 5 questions (5-step scale) adapted from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
A total of 243 patients (166 women, 77 men) with a mean age of 67 years (range 28 - 94) was treated. In the patient's rating, pain at rest as well as in motion decreased significantly from 6.4 +/- 2.1 to 2.9 +/- 2.0 and from 8.1 +/- 1.5 to 4.2 +/- 21, respectively (p < 0.001 for both comparisons). The sum score for the 5 questions with a detailed pain assessment by the physician decreased from 18.8 +/- 3.2 to 11.2 +/- 42 (p < 0.001). A significant pain reduction was also observed for each of the 5 single questions. At the end of observation the proportions of patients with no pain or impairment under different conditions were 5 % (climbing stairs), 14 % (walking), 26 % (standing), 33 % (lying/sitting), and 44 % (sleeping). The most common adverse events were nausea, vomiting, obstipation, and dizziness. Treatment with fentanyl-TTS was usually well-tolerated.
Severe pain caused by arthrosis can be well treated with fentanyl-TTS with a favourable safety profile.
研究芬太尼透皮贴剂（多瑞吉）治疗骨关节炎所致疼痛的疗效和耐受性。
首次对患有髋关节炎和/或膝关节炎引起的重度疼痛患者使用芬太尼透皮贴剂进行治疗，并对其进行为期30天的前瞻性记录。患者使用11级数字评分量表评估疼痛，医生则使用根据西安大略和麦克马斯特大学骨关节炎指数（WOMAC）改编的5个问题（5级量表）进行评估。
共治疗了243例患者（166例女性，77例男性），平均年龄67岁（范围28 - 94岁）。在患者的评分中，静息时和活动时的疼痛分别从6.4±2.1显著降至2.9±2.0，从8.1±1.5降至4.2±2.1（两项比较p均<0.001）。医生进行详细疼痛评估的5个问题的总分从18.8±3.2降至11.2±4.2（p<0.001）。5个单项问题中的每一个也都观察到疼痛显著减轻。观察结束时，在不同情况下无疼痛或无功能障碍的患者比例分别为：上楼梯时5%、行走时14%、站立时26%、躺/坐时33%、睡眠时44%。最常见的不良事件是恶心、呕吐、便秘和头晕。芬太尼透皮贴剂治疗通常耐受性良好。
芬太尼透皮贴剂能有效治疗骨关节炎引起的重度疼痛，且安全性良好。
