Mitra Raj, Jones Stephanie
Stanford Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Redwood City, CA 94063, USA.
Am J Hosp Palliat Care. 2012 Feb;29(1):70-9. doi: 10.1177/1049909111413256. Epub 2011 Jun 28.
Adjuvant analgesics (co-analgesics) are medications whose primary indication is the management of a medical condition with secondary effects of analgesia. Cancer pain is multifactorial and often involves inflammatory, nociceptive, and neuropathic pain subtypes. Adjuvant analgesics used in conjunction with opioids have been found to be beneficial in the management of many cancer pain syndromes; however, they are currently underutilized. Antidepressants, anticonvulsants, local anesthetics, topical agents, steroids, bisphosphonates, and calcitonin are all adjuvants which have been shown to be effective in the management of cancer pain syndromes. When utilizing analgesic adjuvants in the treatment of cancer pain, providers must take into account the particular side effect profile of the medication. Ideally, adjuvant analgesics will be initiated at lower dosages and escalated as tolerated until efficacy or adverse effects are encountered.
辅助镇痛药(协同镇痛药)是一类药物,其主要适应证是治疗某种疾病,同时具有镇痛的次要作用。癌痛是多因素的,通常涉及炎症性、伤害感受性和神经病理性疼痛亚型。已发现与阿片类药物联合使用的辅助镇痛药在许多癌痛综合征的管理中有益;然而,它们目前未得到充分利用。抗抑郁药、抗惊厥药、局部麻醉药、外用剂、类固醇、双膦酸盐和降钙素都是已被证明在癌痛综合征管理中有效的辅助药物。在使用镇痛辅助药物治疗癌痛时,医疗人员必须考虑药物特定的副作用情况。理想情况下,辅助镇痛药应以较低剂量开始使用,并根据耐受情况逐渐增加剂量,直至出现疗效或不良反应。