Ferris F D, Kerr I G, De Angelis C, Sone M, Hume S
Toronto-Bayview Regional Cancer Centre, Sunnybrook Medical Centre, Ontario, Canada.
J Palliat Care. 1990 Summer;6(2):51-9.
Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with increasing frequency (up to 7%) by our oncology inpatients. Eighty-six percent of the 135 inpatients we reviewed realized good pain control with dose rates up to 700 morphine-equivalent (ME) mg/h. Local toxicity occurred on only 10 occasions. Systemic side effects secondary to the infusion were reported 75 times and were generally readily reversed. Myoclonus was seen in 11% of our patients at dose rates as low as 60-90 ME mg/h. Adjuvant therapies were not used as frequently as might be warranted. We believe that narcotic infusions, particularly subcutaneous ones, are safe and effective. Further prospective trials are needed to clarify how they should be combined with other therapies to control cancer pain that is poorly responsive to narcotics, and to better understand the etiology and management of serious side effects.
我们肿瘤内科住院患者使用吗啡和氢吗啡酮输注的持续时间达6天及以上（平均25.75天）的频率越来越高（高达7%）。在我们审查的135例住院患者中，86%的患者在剂量率高达700毫克吗啡当量（ME）/小时的情况下实现了良好的疼痛控制。仅出现10次局部毒性反应。输注引起的全身性副作用报告了75次，且通常很容易逆转。在剂量率低至60 - 90毫克ME/小时时，11%的患者出现了肌阵挛。辅助治疗的使用频率未达应有程度。我们认为，麻醉剂输注，尤其是皮下输注，是安全有效的。需要进一步的前瞻性试验来阐明应如何将其与其他疗法联合使用，以控制对麻醉剂反应不佳的癌症疼痛，并更好地了解严重副作用的病因和管理方法。
