Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Colorado Denver, Aurora, CO, United States.
Division of General Internal Medicine, University of Colorado Denver, Aurora, CO, United States.
Gynecol Oncol. 2018 May;149(2):401-409. doi: 10.1016/j.ygyno.2018.02.008. Epub 2018 Mar 12.
As the only oncologists that provide both medical and surgical care, gynecologic oncologists encounter an exceptionally broad range of indications for prescribing opioids in clinical situations ranging from management of acute post-operative pain to chronic cancer-related pain to end-of-life care. While opioids are essential to the practice of gynecologic oncology, they can also have significant side effects and can be misused. Due to the explosive growth of opioid prescriptions and opioid-related overdoses and deaths during the first decade of the 21st century, there has been a recent concerted public health effort to prevent and treat opioid misuse through both legislation and education [1]. The first article in this two part series focused on appropriate use of opioids across clinical settings. This article addresses both the clinical and regulatory aspects of balancing opioid safety and accessibility for patients with gynecologic cancer.
作为同时提供医疗和手术护理的肿瘤专家,妇科肿瘤学家在临床情况下遇到了广泛的开具阿片类药物的适应症,从管理急性术后疼痛到慢性癌症相关疼痛,再到临终关怀。虽然阿片类药物是妇科肿瘤学实践的重要组成部分,但它们也可能有严重的副作用,并可能被滥用。由于 21 世纪头十年阿片类药物处方和与阿片类药物相关的过量用药和死亡人数的爆炸式增长,最近通过立法和教育[1],人们共同做出了一项公共卫生努力,以预防和治疗阿片类药物滥用。这两篇系列文章的第一篇文章重点介绍了在各种临床环境中合理使用阿片类药物。本文讨论了平衡妇科癌症患者的阿片类药物安全性和可及性的临床和监管方面。