Lundorff Lena E, Jensen Niels-Henrik
Regionshospitalet Herning, Palliativt Team, Herning.
Ugeskr Laeger. 2007 Oct 29;169(44):3750-2.
Pain in palliative patients demonstrates impact from many dimensions. This article focuses on pain and typical treatment problems in this respect. A pain analysis is mandatory before initiating pharmacological treatment. However, there are often problems with neuropathic and breakthrough pain. A special issue is the possible toxicity of opioids with acute tolerance and central nervous system sensitisation resulting in increased pain intensity. A key word in the treatment of opioid induced problems is opioid rotation. As pain is very dynamic, close monitoring is recommended.
姑息治疗患者的疼痛表现出多方面的影响。本文聚焦于这方面的疼痛及典型治疗问题。在开始药物治疗前必须进行疼痛分析。然而,神经性疼痛和爆发性疼痛常常存在问题。一个特殊问题是阿片类药物可能产生的毒性,伴有急性耐受性和中枢神经系统致敏,导致疼痛强度增加。治疗阿片类药物所致问题的一个关键词是阿片类药物轮换。由于疼痛变化非常动态,建议密切监测。