Sakamoto Ryo, Koyama Atsuko
Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, JPN.
Cureus. 2022 May 24;14(5):e25266. doi: 10.7759/cureus.25266. eCollection 2022 May.
Introduction Pain is one of the most important symptoms in terms of prevalence and a major cause of distress in patients with cancer. Therefore, this study aimed to analyze and identify the factors that influence the worsening of pain in patients with cancer necessitating opioid dose escalation. Methods The study was conducted in a single center. This study is a retrospective cohort study of 390 adult cancer patients. The primary endpoint was dose escalation for strong opioids. Adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated using a logistic regression model to evaluate the relationships of factors with opioid dose escalation for cancer pain. Results Polypharmacy was associated with opioid dose escalation (aOR = 2.54, 95% CI = 1.486-4.370, p = 0.001). Conversely, alcohol consumption was associated with a reduced need for dose escalation (aOR = 0.60, 95% CI = 0.376-0.985, p = 0.043). Conclusion The results of this study indicate that moderate alcohol consumption does not reduce the efficacy of opioids in patients with cancer pain. Meanwhile, patients receiving polypharmacy may be able to more rapidly alleviate their pain via early opioid dose modification.
引言
就患病率而言,疼痛是最重要的症状之一,也是癌症患者痛苦的主要原因。因此,本研究旨在分析和确定影响癌症患者疼痛加剧从而需要增加阿片类药物剂量的因素。
方法
本研究在单一中心进行。这是一项对390名成年癌症患者的回顾性队列研究。主要终点是强效阿片类药物的剂量增加。使用逻辑回归模型计算调整后的优势比(aORs)及其95%置信区间(CIs),以评估各因素与癌症疼痛阿片类药物剂量增加之间的关系。
结果
联合用药与阿片类药物剂量增加相关(aOR = 2.54,95% CI = 1.486 - 4.370,p = 0.001)。相反,饮酒与减少剂量增加的需求相关(aOR = 0.60,95% CI = 0.376 - 0.985,p = 0.043)。
结论
本研究结果表明,适度饮酒不会降低阿片类药物对癌症疼痛患者的疗效。同时,接受联合用药的患者可能能够通过早期调整阿片类药物剂量更快地缓解疼痛。