Palliative Care Unit, Sanatorio Médica Uruguaya, Montevideo, Uruguay.
J Palliat Med. 2011 Nov;14(11):1270-3. doi: 10.1089/jpm.2010.0390. Epub 2011 Jun 1.
A case of severe constipation is described in a 75-year- old cancer patient receiving methadone for pain. Her constipation was refractory to the current treatment and she suffered severe discomfort and cognitive impairment. Due to the severity of the clinical situation and after excluding mechanical obstruction, low doses of subcutaneous neostigmine were administered, having bowel movements with evacuation of stools in a few hours after its administration.
The results suggest that subcutaneous neostigmine could be an alternative choice in a group of selected patients with advanced cancer and opioid-induced constipation.
本文报道了一例 75 岁癌症患者的严重便秘病例,该患者因疼痛接受美沙酮治疗。她的便秘对当前的治疗方法无反应,且伴有严重的不适和认知障碍。由于临床情况严重,且在排除机械性梗阻后,给予小剂量皮下新斯的明,在给药数小时后排便并排出粪便。
结果表明,对于一组晚期癌症合并阿片类药物诱导性便秘的选定患者,皮下新斯的明可能是一种替代选择。