Baba Mika, Gomwo Ikuo
Department of Palliative Care, Saito Yukoukai Hospital, Ibaraki 567-0085.
Masui. 2012 Oct;61(10):1148-52.
Cancer pain consists of continuous pain lasting almost all day and transient exacerbation of pain called breakthrough pain. Breakthrough pain is classified as somatic pain and visceral pain, neuropathic pain according to the character of pain. Although the immediate release opioid is used as the first treatment of choice to breakthrough pain, the effect is not enough when it shows the character of neuropathic pain. Pregabalin has become the first medicine for the treatment of neuropathic pain, and it sometimes reveals prompt analgesic effect based on its pharmacological profile. It has also been reported that pregabalin used with oxycodine reveals analgesic effect with smaller dosage than pregabalin alone. We experienced a young patient with lung cancer suffering from sudden exacerbation of symptomatic sciatica, whose pain was markedly reduced within 30 minutes by taking immediate release oxycodone 5 mg and pregabalin 75 mg simultaneously. Conclusions : Pregabalin with immediate release oxycodone simultaneously may be able to improve acute exacerbation of neuropathic cancer pain rapidly.
癌痛包括几乎整日持续的持续性疼痛以及称为爆发性疼痛的疼痛短暂加剧。爆发性疼痛根据疼痛性质可分为躯体痛、内脏痛和神经病理性疼痛。尽管即释阿片类药物被用作爆发性疼痛的首选初始治疗药物，但当表现出神经病理性疼痛特征时，其效果并不充分。普瑞巴林已成为治疗神经病理性疼痛的一线药物，并且基于其药理学特性，它有时会显示出迅速的镇痛效果。也有报道称，普瑞巴林与羟考酮联合使用时，与单独使用普瑞巴林相比，以更小的剂量即可显示出镇痛效果。我们遇到一名患有肺癌的年轻患者，其症状性坐骨神经痛突然加剧，通过同时服用5毫克即释羟考酮和75毫克普瑞巴林，其疼痛在30分钟内明显减轻。结论：普瑞巴林与即释羟考酮同时使用可能能够迅速改善神经病理性癌痛的急性加剧。
