Kim J G, Sohn S K, Kim D H, Baek J H, Chae Y S, Bae N Y, Kim S Y, Lee K B
Kyungpook National University Hospital, Daegu, Republic of Korea.
Transplant Proc. 2005 Dec;37(10):4488-91. doi: 10.1016/j.transproceed.2005.11.038.
The current study was performed to evaluate the effectiveness and safety of transdermal therapeutic system (TTS) fentanyl in the management of acute pain due to oral mucositis in patients receiving stem cell transplantation. A cohort of consecutive patients with painful oral mucositis were enrolled. Initially, 25 microg/h of TTS fentanyl was administered for the treatment of oral mucositis pain. The pain score, based on a visual analogue scale, and mood and quality of sleep as determined by EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Cancer 30), were all recorded before the treatment, then 2, 6, and 10 days later. Twenty-two patients with hematologic malignancies were enrolled. Three patients were excluded from the response assessment, as their TTS fentanyl treatment was stopped owing to related complaints, including severe dizziness, severe vomiting, and an extensive body rash. The total duration of the treatment was 8 days (range, 6-15 days) and the total amount of TTS fentanyl administered per patient was 2.21 at 25 microg/h and 0.63 at 50 microg/h. Six (31.6%) of the remaining 19 patients required an escalated dose of TTS fentanyl at 50 mug/h. The mean pain scores before treatment and 2, 6, and 10 days later were 6.68, 5.17, 3.42, and 2.13, respectively (P < .001). Eight (42.1%) and seven (36.8%) patients experienced improved sleep and mood after treatment, respectively. The TTS fentanyl was effective in both relieving oral mucositis pain with an excellent tolerability and improving the quality of life for hematological patients receiving high-dose chemotherapy with stem cell transplantation.
本研究旨在评估透皮治疗系统（TTS）芬太尼在接受干细胞移植患者中治疗口腔黏膜炎所致急性疼痛的有效性和安全性。纳入一组连续性的口腔黏膜炎疼痛患者。最初，给予25μg/h的TTS芬太尼治疗口腔黏膜炎疼痛。在治疗前、治疗后2天、6天和10天记录基于视觉模拟量表的疼痛评分，以及由欧洲癌症研究与治疗组织生活质量问卷C30（EORTC QLQ-C30）确定的情绪和睡眠质量。纳入22例血液系统恶性肿瘤患者。3例患者被排除在疗效评估之外，因为他们因包括严重头晕、严重呕吐和广泛皮疹等相关主诉而停止了TTS芬太尼治疗。治疗总时长为8天（范围6 - 15天），每位患者给予TTS芬太尼的总量在25μg/h时为2.21，在50μg/h时为0.63。其余19例患者中有6例（31.6%）需要将TTS芬太尼剂量增至50μg/h。治疗前、治疗后2天、6天和10天的平均疼痛评分分别为6.68、5.17、3.42和2.13（P <.001）。治疗后分别有8例（42.1%）和7例（36.8%）患者睡眠和情绪得到改善。TTS芬太尼在缓解口腔黏膜炎疼痛方面有效且耐受性良好，同时改善了接受干细胞移植大剂量化疗的血液系统患者的生活质量。
