Lux E A, Heine J
Klinik für Schmerz- und Palliativmedizin, Klinikum Lünen - St.-Marien-Hospital, Altstadtstr. 23, 44534, Lünen, Deutschland.
Schmerz. 2011 Dec;25(6):663-7. doi: 10.1007/s00482-011-1101-9.
Only limited data and experience with patient-controlled analgesia (PCA) in outpatients for palliative home care, related to organization, effectiveness and costs are available.
In our retrospective study we analyzed the effectiveness, care intensity and pain reduction of 108 palliative cancer pain patients with PCA, included in a palliative home care system.
After equivalent conversion of the opioid doses from oral/transcutaneus to parenteral administration a dose increase was necessary in 12.9% of the patients. The pain therapy was effective until death for an average of 38.9 days (median 21 days). During 3,889 days of PCA therapy there were 76 unscheduled visits based on technical problems.
In cases of cancer pain patients with failed oral or transcutaneous opioid medication, sufficient pain reduction can be achieved with parenteral drug administration by PCA. Domestic PCA requires a lot of human and financial resources, with trained nursing services and regular house visits by physicians experienced in palliative medicine but this method is sufficient and safe to use.
关于门诊姑息家庭护理中患者自控镇痛（PCA）的组织、有效性和成本，仅有有限的数据和经验。
在我们的回顾性研究中，我们分析了纳入姑息家庭护理系统的108例接受PCA的姑息性癌症疼痛患者的有效性、护理强度和疼痛减轻情况。
在将阿片类药物剂量从口服/经皮给药等效转换为胃肠外给药后，12.9%的患者需要增加剂量。疼痛治疗平均有效至死亡38.9天（中位数21天）。在3889天的PCA治疗期间，有76次因技术问题进行的非计划访视。
对于口服或经皮阿片类药物治疗失败的癌症疼痛患者，通过PCA进行胃肠外给药可实现充分的疼痛减轻。家庭PCA需要大量人力和财力，要有经过培训的护理服务以及有姑息医学经验的医生定期家访，但这种方法使用起来是充分且安全的。
