Cole L, Hanning C D
J Pain Symptom Manage. 1990 Apr;5(2):118-26. doi: 10.1016/s0885-3924(05)80025-9.
The rectal route for the administration of opioid analgesics is often forgotten by physicians seeking alternatives to the oral route. This article reviews the physiology of rectal drug absorption and such data as exists on the different opioids that have been administered by this route. Conventional fatty-based suppositories have a place in the management of chronic pain but the variability in dissolution and drug absorption limit their usefulness. Recently, sustained release vehicles have become available that offer the prospect of the attainment of steady analgesic drug concentrations with once or twice daily dosing. Early studies with the morphine hydrogel suppository suggest that it may be capable of fulfilling this prospect. Their inherent safety, as dose-dumping is impossible, will make them suitable for use in the home.
寻求口服途径替代方法的医生常常会忽略阿片类镇痛药的直肠给药途径。本文回顾了直肠药物吸收的生理学以及通过该途径给药的不同阿片类药物的现有数据。传统的脂肪基栓剂在慢性疼痛管理中占有一席之地，但溶解和药物吸收的变异性限制了它们的效用。最近，缓释制剂已经出现，有望通过每日给药一次或两次达到稳定的镇痛药浓度。早期对吗啡水凝胶栓剂的研究表明，它可能有能力实现这一前景。由于不可能出现剂量倾泻，其固有的安全性将使其适合在家中使用。
