Klivinyi Christoph, Bornemann-Cimenti Helmar
Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
Korean J Pain. 2018 Jan;31(1):3-9. doi: 10.3344/kjp.2018.31.1.3. Epub 2018 Jan 2.
Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation. Other substances, not used in the treatment of pain, such as proton pump inhibitors, antiemetics, and diuretics are also associated with long QT syndrome. When the possible benefits of therapy outweigh the associated risks, slow dose titration and electrocardiography monitoring are recommended.
长QT综合征是一种心脏复极障碍，与尖端扭转型室速风险增加相关。获得性形式最常见的原因是使用特定药物和/或电解质失衡。本综述深入探讨了与慢性疼痛治疗中常用药物相关的QT延长风险。在疼痛医学领域，所有主要药物类别（即非甾体抗炎药、阿片类药物、抗惊厥和抗抑郁药物、大麻素、肌肉松弛剂）都含有增加QT延长风险的药物。其他未用于疼痛治疗的物质，如质子泵抑制剂、止吐药和利尿剂也与长QT综合征有关。当治疗的潜在益处超过相关风险时，建议缓慢滴定剂量并进行心电图监测。
