老年人慢性疼痛的管理：聚焦于透皮丁丙诺啡
Management of chronic pain in the elderly: focus on transdermal buprenorphine.
作者信息
Vadivelu Nalini, Hines Roberta L
机构信息
Department of Anesthesiology,Yale University School of Medicine, New Haven 06520, USA.
出版信息
Clin Interv Aging. 2008;3(3):421-30. doi: 10.2147/cia.s1880.
Abstract
Chronic pain in the elderly is a significant problem. Pharmacokinetic and metabolic changes associated with increased age makes the elderly vulnerable to side effects and overdosing associated with analgesic agents. Therefore the management of chronic cancer pain and chronic nonmalignant pain in this growing population is an ongoing challenge. New routes of administration have opened up new treatment options to meet this challenge. The transdermal buprenorphine matrix allows for slow release of buprenorphine and damage does not produce dose dumping. In addition the long-acting analgesic property and relative safety profile makes it a suitable choice for the treatment of chronic pain in the elderly. Its safe use in the presence of renal failure makes it an attractive choice for older individuals. Recent scientific studies have shown no evidence of a ceiling dose of analgesia in man but only a ceiling effect for respiratory depression, increasing its safety profile. It appears that transdermal buprenorphine can be used in clinical practice safely and efficaciously for treating chronic pain in the elderly.
摘要
老年人的慢性疼痛是一个重大问题。与年龄增长相关的药代动力学和代谢变化使老年人易受镇痛药副作用和过量用药的影响。因此，在这一不断增长的人群中管理慢性癌痛和慢性非恶性疼痛是一项持续的挑战。新的给药途径开辟了新的治疗选择以应对这一挑战。透皮丁丙诺啡基质可使丁丙诺啡缓慢释放，破损时不会产生剂量突释。此外，其长效镇痛特性和相对安全的特点使其成为治疗老年人慢性疼痛的合适选择。它在肾衰竭患者中安全使用，使其成为老年个体的一个有吸引力的选择。最近的科学研究表明，在人体中没有镇痛封顶剂量的证据，只有呼吸抑制的封顶效应，这增加了其安全性。透皮丁丙诺啡似乎可以在临床实践中安全有效地用于治疗老年人的慢性疼痛。
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