Hamaguchi Shinsuke, Ikeda Tomohito
Department of Anesthesia and Pain Medicine, Dokkyo Medical University School of Medicine, Tochigi 321-0293.
Masui. 2013 Jul;62(7):799-807.
Buprenorphine is a chemically synthesized opioid characterized as the partial mu agonist and kappa antagonist, and transdermal buprenorphine patch will be considered useful as a strong analgesic with fewer psychological side effects in the treatment of chronic non-cancer pain. Use of transdermal buprenorphine should be limited for pain relief of intractable muscle skeletal pain that cannot be alleviated with other analgesics. To avoid severe complication and drug abuse or addiction, assessment of pain and medical history including drug dependence by medical team are important before administration of transdermal buprenorphine. Moreover, side effects such as nausea, vomiting, constipation, erythema and itching, loss of appetite should be treated appropriately. When transdermal buprenorphine is administered to chronic pain patients, physicians must examine the condition of patients regularly at an outpatient clinic. Moreover, decreasing and discontinuation of opioid including transdermal buprenorphine should always be considered during the treatment. Most important objective of chronic pain treatment is to improve QOL and ADL of patients.
丁丙诺啡是一种化学合成的阿片类药物，其特点是为μ受体部分激动剂和κ受体拮抗剂，丁丙诺啡透皮贴剂在治疗慢性非癌性疼痛时，被认为是一种强效镇痛药，且心理副作用较少。丁丙诺啡透皮贴剂的使用应限于其他镇痛药无法缓解的顽固性肌肉骨骼疼痛的止痛。为避免严重并发症以及药物滥用或成瘾，在使用丁丙诺啡透皮贴剂之前，医疗团队对疼痛和病史（包括药物依赖情况）进行评估很重要。此外，恶心、呕吐、便秘、红斑、瘙痒、食欲不振等副作用应得到适当治疗。当给慢性疼痛患者使用丁丙诺啡透皮贴剂时，医生必须在门诊定期检查患者的情况。此外，在治疗期间应始终考虑减少和停用包括丁丙诺啡透皮贴剂在内的阿片类药物。慢性疼痛治疗的最重要目标是改善患者的生活质量和日常生活活动能力。
