Tanaka Rei, Ishikawa Hiroshi, Sato Tetsu, Shino Michihiro, Matsumoto Teruaki, Mori Keita, Omae Katsuhiro, Osaka Iwao
1 Department of Pharmacy, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
2 Department of Psycho-Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
Am J Hosp Palliat Care. 2017 Jul;34(6):572-576. doi: 10.1177/1049909116641274. Epub 2016 Mar 31.
Despite the risk of drug-induced delirium, it is difficult to avoid the use of opioids in palliative care. However, no previous study has carefully investigated how the development of delirium varies among patients injected with different opioids for the first time.
To reveal the difference in the incidence of delirium between different opioids.
The incidence of delirium was compared among 114 patients who had started morphine, oxycodone, or fentanyl injection at Shizuoka Cancer Center between June 2012 and September 2014.
The incidence of delirium was 28.9% in the morphine group (n = 38), 19.5% in the oxycodone group (n = 41), and 8.6% in the fentanyl group (n = 35). There was a significant difference between the morphine and fentanyl groups (Fisher's exact test, P = 0.04) but not between the morphine and oxycodone groups (P = 0.43) nor between the oxycodone and fentanyl groups (P = 0.21).
The incidence of delirium after the commencement of fentanyl injection was significantly lower, suggesting that fentanyl is a useful opioid injection drug from the perspective of delirium risk.
尽管存在药物性谵妄的风险，但在姑息治疗中很难避免使用阿片类药物。然而，此前尚无研究仔细调查首次注射不同阿片类药物的患者谵妄的发生情况如何不同。
揭示不同阿片类药物之间谵妄发生率的差异。
比较了2012年6月至2014年9月在静冈癌症中心开始注射吗啡、羟考酮或芬太尼的114例患者的谵妄发生率。
吗啡组（n = 38）的谵妄发生率为28.9%，羟考酮组（n = 41）为19.5%，芬太尼组（n = 35）为8.6%。吗啡组和芬太尼组之间存在显著差异（Fisher精确检验，P = 0.04），但吗啡组和羟考酮组之间（P = 0.43）以及羟考酮组和芬太尼组之间（P = 0.21）无显著差异。
开始注射芬太尼后的谵妄发生率显著较低，表明从谵妄风险的角度来看，芬太尼是一种有用的阿片类注射药物。
