Tajima Tsukasa, Nakaho Toshimichi
Department of Palliative Medicine, Tohoku University Hospital, Sendai, Japan.
Gan To Kagaku Ryoho. 2010 Oct;37(10):1854-9.
Cancer pain management is expected to become more important because of the growing number of cancer patients in the years to come. To improve cancer pain relief requires understanding and adequate application of the WHO three-step analgesic ladder. Selective cox-2 inhibitors have efficacy in decreasing side effects. Tramadol and a new type of transdermal fentanyl patch that provides 24-hour sustained release of fentanyl is commercially available to alleviate pain. New anti-seizure drugs such as Gabapentin and Pregabalin can be used for neuropathic pain and cancer pain as analgesic adjuvant drugs. They allow simple use than with palliative drugs so far. Palliation of cancer pain requires a multi-discipline approach for intensive management of symptoms.
由于未来几年癌症患者数量不断增加,癌症疼痛管理预计将变得更加重要。要改善癌症疼痛缓解情况,需要理解并充分应用世界卫生组织的三阶梯镇痛法。选择性环氧化酶-2抑制剂在减少副作用方面具有疗效。曲马多和一种能提供24小时持续释放芬太尼的新型透皮芬太尼贴剂已上市,可用于缓解疼痛。新型抗癫痫药物如加巴喷丁和普瑞巴林可作为镇痛辅助药物用于神经性疼痛和癌症疼痛。与目前的姑息治疗药物相比,它们使用起来更简便。癌症疼痛的缓解需要采取多学科方法对症状进行强化管理。