Patel Joanne, Lucas Catherine J, Margalit Maxwell, Martin Jennifer H
J Pain Palliat Care Pharmacother. 2018 Jun-Sep;32(2-3):116-123. doi: 10.1080/15360288.2018.1545725. Epub 2019 Feb 8.
To examine the laxative prescriptions in hospital inpatients with cancer and non-cancer pain on oxycodone compared to oxycodone plus naloxone combination.
Retrospective case note review.
A palliative care inpatient unit and a general medical ward in a large tertiary referral hospital.
Eighty-four patients receiving oxycodone or combination oxycodone/naloxone on general medical (45 patients) and palliative care wards (39 patients).
The primary recorded outcomes were regular opioid dose (milligrams per day) and number of prescribed laxatives (type, doses, and frequency per day).
Sixty-three (75%) patients in the study were on at least one laxative. In the general medicine inpatients, those on combined oxycodone/naloxone received on average 3.7 laxative doses per day compared to the oxycodone patients receiving 1.6 doses a day. In the palliative medicine population, both groups received a similar number of laxatives, despite the oxycodone/naloxone patients being on lower opioid doses.
This retrospective study of hospital inpatients with cancer and non-cancer pain found that laxative use was not reduced in those on combined oxycodone/naloxone compared to oxycodone alone, suggesting that despite the interpretations of the clinical trials in the phase IV setting, the addition of naloxone had no effect on reducing laxative use.
比较接受羟考酮治疗的癌症和非癌症疼痛住院患者与接受羟考酮加纳洛酮联合治疗的患者的泻药处方情况。
回顾性病例记录审查。
一家大型三级转诊医院的姑息治疗住院单元和普通内科病房。
84名在普通内科（45名患者）和姑息治疗病房（39名患者）接受羟考酮或羟考酮/纳洛酮联合治疗的患者。
主要记录的结果是常规阿片类药物剂量（每天毫克数）和开具的泻药数量（类型、剂量和每天频率）。
研究中的63名（75%）患者至少使用一种泻药。在普通内科住院患者中，接受羟考酮/纳洛酮联合治疗的患者平均每天接受3.7剂泻药，而接受羟考酮治疗的患者每天接受1.6剂。在姑息治疗人群中，尽管接受羟考酮/纳洛酮治疗的患者阿片类药物剂量较低，但两组接受的泻药数量相似。
这项对癌症和非癌症疼痛住院患者的回顾性研究发现，与单独使用羟考酮相比，接受羟考酮/纳洛酮联合治疗的患者使用泻药的情况并未减少，这表明尽管对IV期临床试验有不同解读，但添加纳洛酮对减少泻药使用没有效果。
