Ospedale Privato Accreditato Villa Pineta srl, Gaiato, Modena, Italy.
Eur Rev Med Pharmacol Sci. 2019 Nov;23(4 Suppl):51-54. doi: 10.26355/eurrev_201911_19370.
We present the case of a 59-year-old woman with third-grade obesity and severe comorbidities including osteoporosis, dyslipidemia, diabetes mellitus, hypertension, night eating following bariatric biliary-intestinal bypass surgery, severe fibromyalgia, poly-arthrosis, lumbar disc herniation in L5S1, sleep disorders and sleep apnea syndrome, and emotional disorders with anxiety and depression, who suffered from chronic pain unresponsive to a combination of multiple analgesics. After a period of metabolic and nutritional rehabilitation, analgesic treatment with tapentadol prolonged release (PR) was started and gradually increased to a daily dose of 300 mg with optimal pain control and a marked improvement in the quality of life and autonomy. Therapy suspension was followed by rebound pain with a worsening in functional capacity, and thus, the patient requested a new rehabilitation treatment, with new benefits. Analgesia is of paramount importance in fragile patients who are undergoing a rehabilitation period, in order to improve compliance with the rehabilitation protocols and increase the success of behavioral therapy. Tapentadol PR can be an effective analgesic therapy for pain control in several settings. Its peculiar tolerability profile improves the acceptability of tapentadol, even in patients with multiple previous analgesic treatments.
我们报告了一例 59 岁的女性患者，她患有三级肥胖症，同时伴有多种严重的合并症，包括骨质疏松症、血脂异常、糖尿病、高血压、减重胆道旁路手术后夜间进食、严重的纤维肌痛、多关节炎、L5S1 腰椎间盘突出、睡眠障碍和睡眠呼吸暂停综合征，以及伴有焦虑和抑郁的情绪障碍，这些问题导致她长期遭受慢性疼痛的折磨，且对多种镇痛药的联合治疗无反应。经过一段时间的代谢和营养康复治疗后，开始使用盐酸他喷他多控释片进行镇痛治疗，并逐渐增加至每日 300mg，以达到最佳的疼痛控制效果，显著改善了生活质量和自主性。停止治疗后，疼痛出现反弹，导致功能能力恶化，因此，患者要求再次进行康复治疗，并取得了新的获益。在进行康复期的脆弱患者中，镇痛至关重要，这可以提高患者对康复方案的依从性，增加行为疗法的成功率。盐酸他喷他多控释片在多种情况下都可以作为有效的镇痛治疗药物，用于控制疼痛。其独特的耐受性特征提高了患者对他喷他多的接受度，即使是在有多种既往镇痛治疗的患者中也是如此。
