Palos Guadalupe R
Division of Internal Medicine, Department of Symptom Research, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA.
Oncol Nurs Forum. 2008 Nov;35 Suppl:13-9. doi: 10.1188/08.ONF.S1.13-19.
PURPOSE/OBJECTIVES: To describe the most common side effects associated with the use of opioid treatment in patients with moderate to severe cancer pain; to discuss research findings specific to the use of opioids for cancer pain in long-term cancer survivors.
Published research, articles from a literature review, and U. S. statistics.
Side effects associated with opioid use are a major contributor to patient reluctance to follow treatment plans for cancer pain. Clinicians must follow the critical steps necessary to build comprehensive treatment plans that include a preventive approach to side effects and opioid rotation when side effects do not resolve.
Side effects associated with long-term use of opioids by cancer survivors are a major contributor to patient reluctance to follow a cancer pain treatment plan. Patient education efforts must promote open and clear communication between survivors and their providers about side effects and other important issues related to long-term use of opioids in managing pain related to cancer and its treatment.
Oncology nurses recognize that patients often require the long-term use of opioids when they experience chronic pain as a result of their disease or its treatment. The long-term physical and cognitive effects of such opioid use are not well known, despite the advances that have been made in cancer pain control and research. Survivors should communicate their concerns about side effects to the treatment team. In addition, patients and family members must be encouraged to inform their providers about personal attitudes, beliefs, and practices that may affect decisions about taking their analgesics as prescribed. Most importantly, oncology nurses must teach patients and their families to self-advocate for optimal pain relief with minimal side effects.
目的/目标：描述中重度癌症疼痛患者使用阿片类药物治疗时最常见的副作用；讨论长期癌症幸存者使用阿片类药物治疗癌症疼痛的具体研究结果。
已发表的研究、文献综述文章及美国统计数据。
与使用阿片类药物相关的副作用是患者不愿遵循癌症疼痛治疗方案的主要原因。临床医生必须遵循必要的关键步骤来制定全面的治疗方案，该方案包括对副作用采取预防措施，以及在副作用无法缓解时进行阿片类药物轮换。
癌症幸存者长期使用阿片类药物产生的副作用是患者不愿遵循癌症疼痛治疗方案的主要原因。患者教育工作必须促进幸存者与其医疗服务提供者之间就副作用以及与长期使用阿片类药物治疗癌症及其相关疼痛的其他重要问题进行开放和清晰的沟通。
肿瘤护理人员认识到，当患者因疾病或其治疗而经历慢性疼痛时，通常需要长期使用阿片类药物。尽管在癌症疼痛控制和研究方面取得了进展，但这种阿片类药物使用的长期身体和认知影响尚不清楚。幸存者应向治疗团队表达他们对副作用的担忧。此外，必须鼓励患者及其家属告知医疗服务提供者可能影响按处方服用镇痛药决策的个人态度、信仰和习惯。最重要的是，肿瘤护理人员必须教导患者及其家属自我主张，以实现副作用最小化的最佳疼痛缓解。
