Palliative Medicine Registrar, Department of Palliative Care, Ninewells Hospital, Dundee, UK.
Scott Med J. 2014 May;59(2):e11-3. doi: 10.1177/0036933014530057. Epub 2014 Mar 27.
Methadone is a synthetic opioid which is being used with increased frequency in the palliative care setting for management of complex pain. There have been cases published reporting the development of oedema with methadone maintenance therapy but no cases on the association with methadone and peripheral oedema in the palliative care setting. As yet, the underlying mechanisms are unclear.
This case report describes a gentleman with ependymoma and difficult-to-control lower back pain and scrotal pain. This pain had failed to respond to other strong opioids. He was prescribed methadone and then subsequently developed bilateral peripheral oedema.
Peripheral oedema resolved following cessation of methadone.
This highlights an important potential adverse effect of methadone in a society of increased methadone prescription for pain control. The published literature to date is reviewed and possible underlying mechanisms explored.
美沙酮是一种合成阿片类药物，在姑息治疗环境中，它被越来越频繁地用于治疗复杂疼痛。已经有报道称，在接受美沙酮维持治疗时会出现水肿，但在姑息治疗环境中，尚未有关于美沙酮与外周水肿之间关联的病例。目前，其潜在机制尚不清楚。
本病例报告描述了一位患有室管膜瘤的男性，他患有难以控制的下背部疼痛和阴囊疼痛。其他强效阿片类药物对此类疼痛无效。他被开了美沙酮，随后出现双侧外周水肿。
停用美沙酮后，外周水肿消退。
这突显了在一个增加美沙酮开具以控制疼痛的社会中，美沙酮的一个重要潜在不良反应。目前对已发表的文献进行了回顾，并探讨了可能的潜在机制。
