Radbruch L, Zech D, Grond S, Jung H
Institut für Anaesthesiologie und Operative Intensivmedizin, Universität zu Köln.
Geburtshilfe Frauenheilkd. 1992 Jul;52(7):404-11. doi: 10.1055/s-2007-1023776.
From 1983-1989, 106 patients with breast cancer were treated in our pain management unit on 6767 treatment days. Pain was caused by bone metastasis in 73% of patients. Neuropathic pain was reported by 32% of the patients. In all but four of these patients, new tumour growth was diagnosed. Patients were treated according to WHO analgesic guidelines with non-opioids on 16% of the days, non-opioids in combination with weak opioids on 36% and with strong opioids on 38% (orally 90%, parenterally 4% of the days). Due to the prevalence of bone pain non-steroidal antiinflammatory drugs were given on 56% of the days. The high incidence of neuropathic pain led to frequent use of co-analgesics (antidepressants 17%, anticonvulsants 12%, steroids 12% of the days). Adjuvant therapy for symptoms other than pain was given on 86% of the days. Whilst 92% of patients reported more than moderate pain on admission, 45% obtained complete pain relief beginning from the first days of treatment. On 92% of the days, patients described their pain as moderate or less. Side effects were treated symptomatically and played a minor role in a reason to change therapy.
1983年至1989年期间，我们疼痛管理科在6767个治疗日里共治疗了106例乳腺癌患者。73%的患者疼痛由骨转移引起。32%的患者报告有神经性疼痛。在这些患者中，除4例之外，均诊断出有新的肿瘤生长。患者按照世界卫生组织的镇痛指南进行治疗，16%的治疗日使用非阿片类药物，36%的治疗日使用非阿片类药物联合弱阿片类药物，38%的治疗日使用强阿片类药物（口服占90%，胃肠外给药占4%）。由于骨痛普遍存在，56%的治疗日给予了非甾体抗炎药。神经性疼痛的高发生率导致辅助镇痛药的频繁使用（抗抑郁药占17%，抗惊厥药占12%，类固醇占12%）。86%的治疗日给予了疼痛以外症状的辅助治疗。虽然92%的患者入院时报告有中度以上疼痛，但45%的患者从治疗第一天开始就实现了完全疼痛缓解。92%的治疗日，患者将其疼痛描述为中度或以下。副作用采用对症治疗，在改变治疗的原因中作用较小。
