Discala Sandra L, Basri Danny, Vartan Christine M, Silverman Michael A
Consult Pharm. 2018 Apr 1;33(4):215-221. doi: 10.4140/TCP.n.2018.215.
Topical morphine is a potential treatment option for painful pressure ulcers in hospice and palliative care patients who favor avoidance of systemic opioid therapy.
A 65-year-old male African-American veteran with a painful stage 3 sacral pressure injury was hesitant to take systemic opioids to control his pain, as he wished to stay alert for family and friends. Topical morphine was initiated, and within 24 hours the patient reported a significant reduction in pain on the numeric rating scale.
Palliative pharmacotherapy is focused on reducing the symptoms of disease while avoiding side effects that impair quality of life. Evidence suggests topical morphine can be an effective treatment option for painful pressure ulcers and can reduce the need for systemic opioids in select patients.
In the palliative care setting, topical morphine may be considered for compassionate use when treatment with systemic analgesics is undesired, inadequate, or poorly tolerated.
对于倾向于避免全身使用阿片类药物治疗的临终关怀和姑息治疗患者，局部使用吗啡是治疗疼痛性压疮的一种潜在选择。
一名65岁的非裔美国男性退伍军人，患有疼痛的3期骶骨压疮，因希望对家人和朋友保持清醒而不愿服用全身性阿片类药物来控制疼痛。开始局部使用吗啡，24小时内患者报告数字评分量表上的疼痛显著减轻。
姑息性药物治疗的重点是减轻疾病症状，同时避免损害生活质量的副作用。有证据表明，局部使用吗啡可能是治疗疼痛性压疮的有效选择，并且可以减少某些患者对全身性阿片类药物的需求。
在姑息治疗环境中，当全身性镇痛药治疗不理想、不足或耐受性差时，可考虑同情使用局部吗啡。
