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[一种用于治疗癌痛的合适阿片类药物轮换方法——阿片类镇痛药全国使用情况调查]

[An appropriate opioid rotation method for treatment of cancer pain--nationwide usage survey of opioid analgesics].

作者信息

Watanabe Norio, Yasumura Mikio, Yamamura Keiko, Yasuda Kimio

机构信息

Dept. of Pharmacy, Hashima Municipal Hospital.

出版信息

Gan To Kagaku Ryoho. 2009 Sep;36(9):1499-503.

Abstract

The use of opioid for treatment of cancer pain has become common with the spread of the WHO method for relief of cancer pain. However, it cannot yet be said whether such usage is appropriate. To understand how opioid analgesics are actually used, we conducted a nationwide mail-based questionnaire survey of doctors dealing with cancer pain treatment. Results indicate that at opioid rotation to fentanyl patch due to insufficient effect, the second opioid is used in a potency equianalgesic or less of the first, so the efficacy of the second is often insufficient. In cases where previous medication had an insufficient effect, taking rescue doses into account, we believe it is important to rotate opioid at 30- 50% above the equianalgesic dose.

摘要

随着世界卫生组织癌症疼痛缓解方法的推广,使用阿片类药物治疗癌症疼痛已变得很普遍。然而,尚不能确定这种用法是否恰当。为了解阿片类镇痛药的实际使用情况,我们针对从事癌症疼痛治疗的医生开展了一项全国性的邮寄问卷调查。结果表明,在因效果不佳而更换为芬太尼透皮贴剂时,第二种阿片类药物的使用剂量与第一种相当或更低,因此第二种药物的疗效往往不足。在先前用药效果不佳的情况下,考虑到使用解救剂量,我们认为以高于等效镇痛剂量30%-50%的剂量更换阿片类药物很重要。

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