癌症患者从口服羟考酮转换为透皮芬太尼时适当剂量的指征
Indication of Adequate Transdermal Fentanyl Dose in Opioid Switching From Oral Oxycodone in Patients With Cancer.
作者信息
Matsumura Chikako, Yamada Masami, Fujihara Saki, Chisaki Yugo, Takahashi Kazushige, Yano Yoshitaka
机构信息
Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan Department of Pharmacy, Osaka-fu Saiseikai Noe Hospital, Osaka, Japan
Department of Pharmacy, Osaka-fu Saiseikai Noe Hospital, Osaka, Japan.
出版信息
Am J Hosp Palliat Care. 2016 Mar;33(2):109-14. doi: 10.1177/1049909114554413. Epub 2014 Oct 16.
OBJECTIVE
The present study aimed to examine affecting factors for conversion ratio and to predict adequate fentanyl dose for patients with cancer pain in opioid switching from oral oxycodone.
METHODS
Patient characteristics, biochemical parameters, daily oxycodone dose, and reasons for opioid switching were retrospectively collected. The effect of variables on the conversion ratio was analyzed by multiple regression analysis.
RESULTS
Regression analysis for the data from 122 patients suggested that the typical conversion ratio was 95:1; however, this ratio was significantly reduced in patients taking a daily oral morphine-equivalent dose of <45 mg/d and in patients with poor pain control to 52:1 and 64:1, respectively.
CONCLUSION
We should carefully and rapidly control pain in opioid switching based on the adequate dose indicated in this study.
目的
本研究旨在探讨转换率的影响因素，并预测从口服羟考酮转换为阿片类药物时癌症疼痛患者的合适芬太尼剂量。
方法
回顾性收集患者特征、生化参数、每日羟考酮剂量以及阿片类药物转换的原因。通过多元回归分析变量对转换率的影响。
结果
对122例患者数据的回归分析表明，典型转换率为95:1；然而，每日口服吗啡当量剂量<45mg/d的患者以及疼痛控制不佳的患者，该比例分别显著降至52:1和64:1。
结论
我们应根据本研究中指出的合适剂量，在阿片类药物转换过程中谨慎且迅速地控制疼痛。
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