Mather L E
Department of Anesthesia and Pain Management, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia.
Acta Anaesthesiol Belg. 1992;43(1):5-20.
With patient control over dosage regimens as in PCA, the pharmacodynamic properties of the opioid analgesic agents emerge as being of greater importance than the pharmacokinetic properties in obtaining a salutary result. However, the prescription of opioid analgesic agents for PCA is more complex than for the same drugs under conventional control. There are major differences in the physicochemical, receptor selectivity and pharmacokinetic properties among opioid analgesic agents. Improved understanding of these differences, it is contended, can lead to more optimized strategies for the clinical management of pain whether under conventional or patient control. The impact of these properties on the components of the PCA prescription is discussed.
在患者自控镇痛（PCA）中，由于患者可控制给药方案，在获得有益效果方面，阿片类镇痛药的药效学特性比药代动力学特性更为重要。然而，用于PCA的阿片类镇痛药的处方比传统控制下使用相同药物更为复杂。阿片类镇痛药在物理化学、受体选择性和药代动力学特性方面存在重大差异。有人认为，更好地理解这些差异可以为传统控制或患者控制下的疼痛临床管理带来更优化的策略。本文讨论了这些特性对PCA处方各组成部分的影响。
