Cameron J C
Rhode Island Hospital, Providence 02903.
Cancer Nurs. 1992 Oct;15(5):372-7.
Constipation is a well-known side effect of narcotics and can add to the total burden of pain of cancer patients in need of pain medication. There is little literature on this topic, and it has been suggested that one reason is that the definitions are vague and socially bound. It has also been suggested that some physicians consider constipation a trivial problem, resulting in a relative lack of attention to the subject. Although this article addresses narcotic-induced constipation, other types related to poor dietary and exercise habits and to disease are mentioned and may be contributing factors. There are a number of drugs and treatments available to treat the problem, but the emphasis of nursing care should be on prevention of constipation. Senna derivatives have been noted to reverse the major constipating effect of narcotics, i.e., the decrease in propulsive movements of the colon, and it is recommended they be given right along with narcotics as a preventive measure. A protocol that incorporates a schedule of drugs and dosages and specific patient and nursing guidelines for daily evaluation of bowel function, with education about dietary, fluid, and exercise requirements, will help nurses practice prevention and contribute to patients' comfort.
便秘是麻醉药品众所周知的副作用，它会加重需要使用止痛药物的癌症患者的整体疼痛负担。关于这个主题的文献很少，有人认为原因之一是定义模糊且受社会因素限制。也有人认为一些医生将便秘视为一个小问题，导致对该主题相对缺乏关注。尽管本文讨论的是麻醉药品引起的便秘，但也提到了与不良饮食和运动习惯以及疾病相关的其他类型的便秘，它们可能也是促成因素。有多种药物和治疗方法可用于解决这个问题，但护理的重点应该是预防便秘。已注意到番泻叶衍生物可逆转麻醉药品的主要致便秘作用，即结肠推进运动的减少，建议将其与麻醉药品一起作为预防措施使用。一个包含药物和剂量时间表以及用于每日评估肠道功能的具体患者和护理指南，并对饮食、液体和运动要求进行教育的方案，将有助于护士进行预防并提高患者的舒适度。
