Shir Y, Shapira S S, Shenkman Z, Kaufman B, Magora F
Department of Anesthesiology, Hadassah University Hospital, Jerusalem, Israel.
Clin J Pain. 1991 Dec;7(4):339-41. doi: 10.1097/00002508-199112000-00014.
Seventy cancer patients suffering from visceral or somatic pain received continuous epidural methadone (EM) analgesia. Initially, 4 mg of 0.1% methadone was given three times daily. If this dose proved ineffective, it was gradually increased to 8 mg four times daily. With this regimen good pain control was obtained in 56 patients (80%). Patients continued the EM therapy for periods up to 140 days, with an average duration of 27 days. Morphine was substituted for methadone in 14 patients (20%). Four of these patients responded well and continued treatment for an average of 18 days. No serious side effects have been observed with EM. With a proper selection of patients and following strict therapy guidelines, epidural methadone is efficacious in treating cancer pain.
70名患有内脏或躯体疼痛的癌症患者接受了持续硬膜外美沙酮（EM）镇痛治疗。最初，每天三次给予4毫克0.1%的美沙酮。如果该剂量证明无效，则逐渐增加至每天四次8毫克。采用这种方案，56名患者（80%）获得了良好的疼痛控制。患者持续接受EM治疗长达140天，平均持续时间为27天。14名患者（20%）用吗啡替代了美沙酮。其中4名患者反应良好，平均继续治疗了18天。未观察到EM有严重副作用。通过适当选择患者并遵循严格的治疗指南，硬膜外美沙酮在治疗癌症疼痛方面是有效的。
