Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Georgetown University School of Medicine, Washington, DC, USA.
Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):355-368. doi: 10.1016/j.bpa.2020.06.005. Epub 2020 Jul 3.
Reclassification of chronic pain as a disease may be helpful because patients with chronic pain require significant treatment and rehabilitation with a clear diagnosis. This can help address critical factors including suffering, quality of life, participation, and with family and social life, which continue to become more important in evaluating the quality of the health care we give our patients today. During the past decade of the opioid epidemic, methadone was the primary treatment for opioid addiction until buprenorphine was approved. Buprenorphine's high-affinity partial agonist properties make it a good alternative to methadone due to lower abuse potential and safer adverse effect profile while maintaining significant efficacy. Expanded out-patient prescribing options have allowed physician and physician extenders such as physician assistants and nurse practitioners to treat these patients that otherwise would have been required to utilize methadone. With unique pharmacological properties, buprenorphine is a safe and effective analgesic for chronic pain. The literature for buprenorphine shows great potential for its utilization in the treatment of chronic pain.
慢性疼痛的重新分类可能是有帮助的，因为慢性疼痛患者需要明确的诊断，并进行大量的治疗和康复。这有助于解决关键因素，包括痛苦、生活质量、参与度以及与家庭和社会生活的关系，这些因素在评估我们今天为患者提供的医疗质量方面变得越来越重要。在过去十年的阿片类药物流行期间，美沙酮是治疗阿片类药物成瘾的主要药物，直到丁丙诺啡获得批准。丁丙诺啡具有高亲和力的部分激动剂特性，使其成为美沙酮的良好替代品，因为它的滥用潜力较低，不良反应谱更安全，同时保持显著的疗效。扩大门诊处方选择使医生和医生助手（如医师助理和执业护士）能够治疗这些患者，否则这些患者将需要使用美沙酮。丁丙诺啡具有独特的药理学特性，是一种安全有效的慢性疼痛治疗药物。丁丙诺啡的文献表明，它在治疗慢性疼痛方面有很大的潜力。
