Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yonsei Med J. 2012 Jul 1;53(4):788-93. doi: 10.3349/ymj.2012.53.4.788.
Chronic low back pain is a common clinical problem. As medication, non-steroidal anti-inflammatory drugs are generally used; however, they are sometimes non-effective. Recently, opioids have been used for the treatment of chronic low back pain, and since 2010, transdermal fentanyl has been used to treat chronic non-cancer pain in Japan. The purpose of the current study was to examine the efficacy of transdermal fentanyl in the treatment of chronic low back pain.
This study included patients (n=62) that suffered from chronic low back pain and were non-responsive to non-steroidal anti-inflammatory drugs. Their conditions consisted of non-specific low back pain, multiple back operations, and specific low back pain awaiting surgery. Patients were given transdermal fentanyl for chronic low back pain. Scores of the visual analogue scale and the Oswestry Disability Index, as well as adverse events were evaluated before and after therapy.
Overall, visual analogue scale scores and Oswestry Disability Index scores improved significantly after treatment. Transdermal fentanyl (12.5 to 50 μg/h) was effective in reducing low back pain in 45 of 62 patients; however, it was not effective in 17 patients. Patients who experienced the most improvement were those with specific low back pain awaiting surgery. Adverse events were seen in 40% of patients (constipation, 29%; nausea, 24%; itching, 24%).
Transdermal fentanyl significantly improved visual analog scale scores and Oswestry Disability Index scores in 73% of patients, especially those with specific low back pain awaiting surgery; however, it did not decrease pain in 27% of patients, including patients with non-specific low back pain or multiple back operations.
慢性下腰痛是一种常见的临床问题。作为药物，一般使用非甾体抗炎药；然而，它们有时并不有效。最近，阿片类药物被用于治疗慢性下腰痛，自 2010 年以来，芬太尼透皮贴剂已在日本用于治疗慢性非癌痛。本研究的目的是探讨芬太尼透皮贴剂治疗慢性下腰痛的疗效。
本研究纳入了（n=62）患有慢性下腰痛且对非甾体抗炎药无反应的患者。他们的病情包括非特异性下腰痛、多次腰部手术和特定的下腰痛等待手术。对这些患者使用芬太尼透皮贴剂治疗慢性下腰痛。在治疗前后评估视觉模拟评分和 Oswestry 残疾指数以及不良反应。
总体而言，视觉模拟评分和 Oswestry 残疾指数在治疗后均显著改善。12.5 至 50μg/h 的芬太尼透皮贴剂对 62 例患者中的 45 例有效，对 17 例无效。改善最明显的患者是那些特定的下腰痛等待手术的患者。40%的患者出现不良反应（便秘 29%，恶心 24%，瘙痒 24%）。
芬太尼透皮贴剂显著改善了 73%患者的视觉模拟评分和 Oswestry 残疾指数，尤其是那些特定的下腰痛等待手术的患者；然而，它并没有减轻 27%的患者的疼痛，包括非特异性下腰痛或多次腰部手术的患者。
