医学监督下使用多学科方法逐渐减少超量阿片类药物剂量治疗伴显著合并症：病例报告。
Medically supervised taper for ultra high-dose opioids with significant comorbidities using a multidisciplinary approach: A case report.
机构信息
Department of Anesthesiology, Pain Clinic, University of Texas Medical Branch, Galveston, Texas.
Center of Addiction Research Department, University of Texas Medical Branch, Galveston, Texas.
出版信息
J Opioid Manag. 2022 Jan-Feb;18(1):85-90. doi: 10.5055/jom.2022.0698.
INTRODUCTION
The opioid epidemic and current opioid use guidelines for chronic noncancer pain have resulted in an overwhelmingly large number of patients undergoing opioid tapers. Even though the literature for tapering guidelines is growing, there is little guidance for tapering patients on ultra high-dose opioids.
CASE DESCRIPTION
This case report describes in detail the opioid tapering approach used to taper a 53-year-old male with chronic low back pain on a regimen of a morphine equivalent daily dose (MEDD) of 1,990 mg. Patient reported many side effects such as chronic nausea, irritability, psychomotor depression, and functional impairment. He was admitted for a medically supervised opioid taper for 12 days.
RESULTS
The patient was discharged with an MEDD of 392 mg with additional taper as an outpatient to an MEDD of 200 mg. Adequate pain relief and resolution of side effects were achieved without the patient reporting significant withdrawal symptomatology in the outpatient setting.
简介
阿片类药物流行和目前用于慢性非癌痛的阿片类药物使用指南导致大量患者接受阿片类药物逐渐减量。尽管逐渐减量指南的文献越来越多，但对于使用超高剂量阿片类药物的患者，几乎没有减量指导。
病例描述
本病例报告详细描述了对一名 53 岁男性慢性腰痛患者进行阿片类药物逐渐减量的方法，该患者的吗啡等效日剂量（MEDD）为 1990 毫克。患者报告有许多副作用，如慢性恶心、易怒、精神运动性抑郁和功能障碍。他因接受 12 天的医学监督阿片类药物逐渐减量而入院。
结果
患者出院时 MEDD 为 392 毫克，随后作为门诊患者进一步逐渐减量至 MEDD 为 200 毫克。在门诊环境中，患者报告没有明显的戒断症状，同时也获得了足够的疼痛缓解和副作用的解决。
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