Pain Therapy Unit, OO.RR, Bergamo, Italy.
Eur Rev Med Pharmacol Sci. 2010 Mar;14(3):185-90.
Visceral pain is a significant issue for patients, and the importance of treating pain is underestimated. New opioid formulations, the primary treatment option for moderate-to-severe pain, have been shown to be effective, but no studies have been conducted to address the efficacy of these agents for visceral pain. This study was conducted to determine the incidence of visceral pain in patients with uncontrolled moderate-to-severe pain, and to evaluate the efficacy of controlled-release (CR) oxycodone in this context.
s: In this multicenter, prospective, observational study, 967 of 980 evaluated patients were included, 350 (36.2%) of whom presented mainly visceral pain. In most cases (57.0%), patients had experienced pain for < or = 3 months, and the majority (94.9%) were cancer patients. Pain was uncontrolled in 340 (97.1%) patients, and was rated as severe in >2/3 of patients (mean numerical rating scale (NRS) value 7.04 +/- 1.68). Patients with uncontrolled pain were given oxycodone CR; all completed the 15-day study and no patient was switched to an alternative opioid.
Oxycodone CR was associated with significant reductions in mean NRS value at day 3, 7 and 15 (final mean NRS 2.37 +/- 1.59) and the proportion of patients experiencing severe pain had decreased by the end of the study to 1.5%. The SF-12 questionnaire showed significant improvements in quality of life in all domains, and oxycodone CR was well tolerated.
Oxycodone CR appears to be a very well tolerated and effective treatment for patients with visceral pain.
内脏痛是患者面临的重大问题,但人们对疼痛的重视程度仍远远不够。新的阿片类药物制剂是治疗中重度疼痛的主要选择,已被证实具有疗效,但目前尚未有研究专门针对这些药物治疗内脏痛的效果。本研究旨在明确中重度疼痛未得到控制患者中内脏痛的发生率,并评估控释型羟考酮在此情况下的疗效。
在这项多中心、前瞻性、观察性研究中,共纳入了 980 例患者中的 967 例,其中 350 例(36.2%)患者主要表现为内脏痛。大多数患者(57.0%)的疼痛病史<或=3 个月,且绝大多数(94.9%)为癌症患者。340 例(97.1%)患者的疼痛未得到控制,且超过 2/3 的患者自述疼痛严重(平均数字评分量表(NRS)值为 7.04 +/- 1.68)。对于这些疼痛未得到控制的患者,给予控释型羟考酮治疗;所有患者均完成了为期 15 天的研究,且无患者换用其他阿片类药物。
控释型羟考酮可显著降低患者的平均 NRS 值,治疗第 3、7 和 15 天的 NRS 值分别为(最终平均 NRS 2.37 +/- 1.59),且研究结束时,自述严重疼痛的患者比例已降至 1.5%。SF-12 问卷显示,所有领域的生活质量均显著改善,且控释型羟考酮具有良好的耐受性。
控释型羟考酮似乎是一种非常耐受良好且有效的内脏痛治疗药物。