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[癌症患儿的鞘内吗啡治疗]

[Intrathecal morphine therapy in children with cancer].

作者信息

Meignier M, Ganansia M F, Lejus C, Testa S

机构信息

Département d'Anesthésiologie, Nantes.

出版信息

Cah Anesthesiol. 1992;40(7):487-90.

PMID:1477771
Abstract

Five children with cancer pain were given continuous intrathecal morphine or fentanyl infusion associated with bupivacaine 0.25% without epinephrine. The morphine daily dose varied from 0.1 mg.kg-1 to 1 mg.kg-1, the maximum daily dose of fentanyl was 0.1 mg.kg-1 associated with the same dose of intravenous fentanyl, and the maximum daily dose of bupivacaine was 1 mg.kg-1. Intrathecal treatment was started after oral and epidural morphine treatment had failed. The children were at home, under the care of several nurses and physicians. A satisfactory analgesia was achieved until demise occurred. In all children, urinary retention was the only side effect of the therapy. Therefore, intrathecal opioid and bupivacaine may be indicated after oral morphine therapy has failed in children with advanced cancer refractory pain.

摘要

五名患有癌痛的儿童接受了持续鞘内注射吗啡或芬太尼,并联合使用不含肾上腺素的0.25%布比卡因。吗啡的日剂量从0.1mg/kg至1mg/kg不等,芬太尼的最大日剂量为0.1mg/kg,同时静脉注射相同剂量的芬太尼,布比卡因的最大日剂量为1mg/kg。在口服和硬膜外注射吗啡治疗失败后开始鞘内治疗。这些儿童在家中,由多名护士和医生照料。在死亡发生前均实现了满意的镇痛效果。在所有儿童中,尿潴留是该治疗唯一的副作用。因此,对于晚期癌症难治性疼痛的儿童,在口服吗啡治疗失败后,鞘内注射阿片类药物和布比卡因可能是一种选择。

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