Boon Martijn, van Dorp Eveline, Broens Suzanne, Overdyk Frank
Department of Anesthesiology, Leiden university medical Center, Leiden, The Netherlands.
Department of Anesthesiology, Netherlands cancer institute, Amsterdam, The Netherlands.
Ann Palliat Med. 2020 Mar;9(2):542-557. doi: 10.21037/apm.2019.12.09. Epub 2020 Feb 6.
Opioids and benzodiazepines are increasingly used alone or in combination. However, the combined use of these agents increases the risk for potentially lethal respiratory depression. This review summarizes current evidence on the effects of the combined use of opioids and benzodiazepines on mortality and severe respiratory adverse events. The results of 29 included manuscripts showed that concomitant use of opioids and benzodiazepines increased the risk for these outcomes in most of clinical and non-clinical settings. However, the risk for harm and benefit of the drug combination strongly correlates to its context and there are situations, such as in the hospice setting, where benefits may outweigh the risks.
阿片类药物和苯二氮䓬类药物越来越多地单独使用或联合使用。然而,这些药物的联合使用会增加潜在致命性呼吸抑制的风险。本综述总结了关于阿片类药物和苯二氮䓬类药物联合使用对死亡率和严重呼吸不良事件影响的现有证据。纳入的29篇手稿结果显示,在大多数临床和非临床环境中,阿片类药物和苯二氮䓬类药物的联合使用会增加这些结果的风险。然而,药物组合的危害风险和益处与其使用背景密切相关,在某些情况下,如临终关怀环境中,益处可能大于风险。