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一名神经性疼痛患者从透皮芬太尼成功转换为透皮丁丙诺啡:病例报告

A successful switch from transdermal fentanyl to transdermal buprenorphine in a patient with neuropathic pain: a case report.

作者信息

Leppert Wojciech

机构信息

1Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Am J Hosp Palliat Care. 2014 Feb;31(1):101-4. doi: 10.1177/1049909112472722. Epub 2013 Jan 23.

Abstract

Buprenorphine is a frequently used opioid in the treatment of neuropathic pain component that is often present in patients with cancer. A case of a 41-year-old patient was depicted whose pain syndrome was associated with the chondrosarcoma growth originating from the sacral bone and numerous surgical interventions and radiotherapy. Improvement in analgesia and good toleration of therapy were observed after switching from transdermal fentanyl to transdermal buprenorphine while maintaining treatment with antidepressants and anticonvulsants. This case report indicates a possibility of a safe switch of transdermal opioids at home, which may provide benefits in terms of analgesia and adverse effects and in consequence have positive impact on the patients' quality of life. This is also accompanied by constant psychological, social, and spiritual support provided to the patient and family.

摘要

丁丙诺啡是治疗癌症患者常出现的神经性疼痛成分时常用的阿片类药物。描述了一例41岁患者的病例,其疼痛综合征与起源于骶骨的软骨肉瘤生长以及多次手术干预和放疗有关。在从透皮芬太尼转换为透皮丁丙诺啡的同时维持抗抑郁药和抗惊厥药治疗后,观察到镇痛效果改善且治疗耐受性良好。该病例报告表明在家中安全转换透皮阿片类药物是有可能的,这在镇痛和不良反应方面可能带来益处,从而对患者的生活质量产生积极影响。这还伴随着为患者及其家人提供持续的心理、社会和精神支持。

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