Department of Respiratory Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan.
Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
BMC Palliat Care. 2014 Oct 8;13:46. doi: 10.1186/1472-684X-13-46. eCollection 2014.
The effectiveness and safety of switch from oral oxycodone to fentanyl patch is little known. Here, we investigated if early phase opioid switch from low dose of oral oxycodone to transdermal fentanyl matrix patch provided any benefits for patients with thoracic malignancy and stable cancer-related pain.
This open-label two-centered prospective study enrolled patients with thoracic malignancy suffering persistent malignancy-related pain with numeric rating scale of pain intensity ≤ 3 which had been controlled by oral oxycodone ≤ 20 mg/day. Eligible patients switched from oral oxycodone to 12.5 μg/h of transdermal fentanyl matrix patch. The dose was allowed to be titrated upwards every 3 day by 25-50%, except for the first increase from 12.5 μg/hr to 25 μg/hr,until achieving adequate pain control. The data on patients' global assessment scores measured on a five-step scale, an 11-point numeric rating scale of pain intensity, the severity of adverse effects using a four-point categorical rating scale, and the Epworth sleepiness scale questionnaire were collected for 15 days.
Forty-nine eligible patients were analyzed. Overall patients' satisfaction score significantly improved from day 1 (2.7 ± 0.9) to day 15 (2.3 ± 0.9) (p < 0.05), and 90% and 78% of patients remained to receive the minimum dose of fentanyl patch on day 8 and 15 from the opioid switch. There was a significant difference in sleepiness throughout the study period, though no difference was detected in pain intensity and other adverse effects.
Transdermal fentanyl matrix patch is an alternative analgesic option for a stable cancer pain in patients with thoracic malignancies.
将口服羟考酮转换为芬太尼贴剂的有效性和安全性知之甚少。在这里，我们研究了从低剂量口服羟考酮转换为经皮芬太尼基质贴片是否能为患有胸部恶性肿瘤和稳定的癌痛患者带来益处。
这是一项开放标签、两中心的前瞻性研究，纳入了患有胸部恶性肿瘤且持续存在疼痛强度数字评分量表（NRS）≤3 的疼痛强度的患者，这些患者的疼痛已经通过口服羟考酮（≤20mg/天）得到了控制。符合条件的患者从口服羟考酮转换为 12.5μg/h 的经皮芬太尼基质贴片。剂量允许每 3 天增加 25-50%，但从 12.5μg/hr 增加到 25μg/hr 的首次增加除外，直到达到充分的疼痛控制。在 15 天内收集了患者整体评估评分（采用五分制量表）、疼痛强度的 NRS 评分（11 分制）、使用四分制分类量表评估的不良反应严重程度以及 Epworth 嗜睡量表问卷的相关数据。
分析了 49 名符合条件的患者。总体而言，患者满意度评分从第 1 天（2.7±0.9）显著改善到第 15 天（2.3±0.9）（p<0.05），并且 90%和 78%的患者在第 8 天和第 15 天从阿片类药物转换后仍然接受芬太尼贴片的最低剂量。尽管在疼痛强度和其他不良反应方面没有差异，但整个研究期间嗜睡程度有显著差异。
对于患有胸部恶性肿瘤的稳定癌痛患者，经皮芬太尼基质贴片是一种替代的镇痛选择。
