Kalso Eija
Department of Anaesthesia and Intensive Care Medicine, Pain Clinic, Helsinki University Central Hospital, P.O. Box 340, FIN-00029 HUS, Finland.
Eur J Pain. 2005 Apr;9(2):131-5. doi: 10.1016/j.ejpain.2004.05.007.
Opioid effectiveness can be improved by individualizing dosing, route of administration and the drug. Particularly in the treatment of chronic non-cancer pain, careful patient selection is essential. The current review concentrates on new ideas about improving opioid effectiveness by increasing efficacy or reducing adverse effects by combining other drugs that modulate opioid receptor mediated effects. These pharmacological "oipioid adjuvants" include e.g. alpha(2)-adrenergic agonists, non-steroidal anti-flammatory analgesics, NMDA-receptor antagonists, CCK-antagonists, gabapentinoids and NK-1 receptor antagonists. The theoretical background and the clinical evidence of these combinations will be discussed.
通过个体化给药剂量、给药途径和药物种类，可以提高阿片类药物的疗效。特别是在治疗慢性非癌性疼痛时，仔细选择患者至关重要。本综述主要关注通过增加疗效或联合其他调节阿片受体介导作用的药物来减少不良反应，从而提高阿片类药物疗效的新思路。这些药理学上的“阿片类佐剂”包括例如α（2）-肾上腺素能激动剂、非甾体抗炎镇痛药、NMDA受体拮抗剂、CCK拮抗剂、加巴喷丁类药物和NK-1受体拮抗剂。将讨论这些联合用药的理论背景和临床证据。
