Ahuja Deepti, Bharati Sachidanand Jee, Mishra Seema, Bhatnagar Sushma
Department of Oncoanaesthesia and Palliative Medicine, Dr. BRA IRCH, AIIMS, New Delhi, India.
Indian J Palliat Care. 2017 Oct-Dec;23(4):480-483. doi: 10.4103/IJPC.IJPC_74_17.
A 32-year-old female, diagnosed case of neuroendocrine tumor of pancreas, was admitted to the pain and palliative care unit with complaints of diffuse abdominal pain which was severe in intensity with score on numerical rating scale-9/10. Pain was not relieved even after taking tablet morphine immediate release 360 mg every 4 hourly, paracetamol 500 mg 6 hourly, and gabapentin 300 mg 8 hourly. She had undergone distal pancreatectomy with splenectomy and also received multiple lines of chemotherapy. After making a diagnosis of opioid-induced hyperalgesia, opioid rotation from morphine to fentanyl was done. This case report reflects various conditions where strong opioids fail to relieve cancer pain, and a multimodal approach is needed for its management.
一名32岁女性，被诊断为胰腺神经内分泌肿瘤，因弥漫性腹痛入院至疼痛与姑息治疗科，腹痛剧烈，数字评分量表评分为9/10。即使每4小时服用360毫克即释吗啡片、每6小时服用500毫克对乙酰氨基酚以及每8小时服用300毫克加巴喷丁，疼痛仍未缓解。她接受了胰体尾切除术加脾切除术，还接受了多线化疗。在诊断为阿片类药物诱导的痛觉过敏后，将阿片类药物从吗啡转换为芬太尼。本病例报告反映了强阿片类药物无法缓解癌痛的各种情况，需要采用多模式方法进行管理。
