突破性癌痛：药物治疗的系统评价
Breakthrough Cancer Pain: A Systematic Review of Pharmacologic Management .
作者信息
Brant Jeannine M, Rodgers Barbara B, Gallagher Eva, Sundaramurthi Thiruppavai
机构信息
Billings Clinic Hospital.
Fox Chase Cancer Center.
出版信息
Clin J Oncol Nurs. 2017 Jun 1;21(3 Suppl):71-80. doi: 10.1188/17.CJON.S3.71-80.
BACKGROUND: Breakthrough cancer pain (BtCP), defined as a transient exacerbation of pain that occurs in conjunction with well-controlled background pain, is a common and burdensome problem in patients with cancer. .
OBJECTIVES: The aim of this systematic review is to identify evidence-based pharmacologic modalities for adequate management of BtCP. .
METHODS: PubMed and CINAHL® databases were searched to identify literature regarding pharmacologic strategies for BtCP published from January 2006 to June 2016. These studies were then synthesized by the Oncology Nursing Society Putting Evidence Into Practice pain team. .
FINDINGS
Forty-four studies provide evidence for the use of opioids for the management of BtCP. Transmucosal immediate-release fentanyl (TIRF) was found to have the most evidence for BtCP. Five studies and guidelines also suggest that oral opioids (not including TIRF products) be dosed proportionally to baseline opioids at 10%-20% of the 24-hour, around-the-clock dose.
背景
突破性癌痛（BtCP）定义为在背景疼痛得到良好控制的情况下出现的疼痛短暂加剧，是癌症患者中常见且负担沉重的问题。
目的
本系统评价的目的是确定基于证据的药物治疗方法，以充分管理突破性癌痛。
方法
检索PubMed和CINAHL®数据库，以识别2006年1月至2016年6月发表的关于突破性癌痛药物治疗策略的文献。然后，肿瘤护理学会循证实践疼痛团队对这些研究进行了综合分析。
结果
44项研究为使用阿片类药物治疗突破性癌痛提供了证据。发现经黏膜即释芬太尼（TIRF）治疗突破性癌痛的证据最多。五项研究和指南还建议，口服阿片类药物（不包括TIRF产品）的剂量应按基线阿片类药物的比例，为24小时全天候剂量的10%-20%。
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