Passik Steven D, Kirsh Kenneth L
Memorial Sloan Kettering Cancer Center and Weil Medical College of Cornell University, New York, New York 10021, USA.
J Pain Palliat Care Pharmacother. 2007;21(1):39-41.
There is a notion that tolerance is an inevitable complication when patients are maintained on opioid analgesic regimens for an extended period of time. Whether this is true or not, it is important to remember that, in spite of growing regulatory scrutiny and spreading fear around these medications, defining "ceiling doses" of opioids has more to do with clinician comfort and much less to do with reality and patient requirements. This commentary posits that clinicians must return to the principles of balancing efficacy with toxicity as the dose-limiting factor once again, contextualized by outcomes in the areas of function and compliant drug-taking.
有一种观点认为，当患者长期使用阿片类镇痛方案时，耐受性是不可避免的并发症。无论这是否属实，重要的是要记住，尽管对这些药物的监管审查日益严格，恐惧情绪不断蔓延，但确定阿片类药物的“封顶剂量”更多地与临床医生的舒适度有关，而与现实情况和患者需求关系较小。本评论认为，临床医生必须再次回归到以疗效与毒性平衡作为剂量限制因素的原则，以功能和药物依从性方面的结果为背景。
