Chambers W A
Department of Anaesthesia and Pain Management, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK.
Br J Anaesth. 2008 Jul;101(1):95-100. doi: 10.1093/bja/aen105. Epub 2008 May 20.
Although between 85% and 90% of patients with advanced cancer can have their pain well controlled with the use of analgesic drugs and adjuvants, there are some patients who will benefit from an interventional procedure. This includes a variety of nerve blocks and also some neurosurgical procedures. Approximately 8-10% of patients may benefit from a peripheral nerve block and around 2% from a central neuraxial block. The most common indication is because opioid dose escalation is limited by signs of opioid toxicity but some patients will benefit from one component of their pain being relieved by a simple peripheral block. Most patients about to undergo these procedures are already taking high doses of opiods and obtaining valid consent may pose problems. The use of peripheral nerve blocks, epidural and intrathecal infusions, and plexus blocks is discussed.
尽管85%至90%的晚期癌症患者使用镇痛药和辅助药物可使疼痛得到良好控制，但仍有一些患者将从介入治疗中获益。这包括各种神经阻滞以及一些神经外科手术。约8%至10%的患者可能从外周神经阻滞中获益，约2%的患者从中枢神经轴阻滞中获益。最常见的适应证是阿片类药物剂量增加受阿片类药物毒性体征限制，但一些患者将从简单外周阻滞缓解其部分疼痛中获益。大多数即将接受这些治疗的患者已经在服用高剂量阿片类药物，获得有效同意可能会出现问题。本文讨论了外周神经阻滞、硬膜外和鞘内输注以及神经丛阻滞的应用。
