Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Curr Opin Support Palliat Care. 2023 Jun 1;17(2):90-97. doi: 10.1097/SPC.0000000000000641. Epub 2023 Mar 15.
Tapentadol is the first of a new class of analgesics, having synergistic µ-opioid receptor agonist and noradrenaline reuptake inhibitory actions. It has been widely researched in many areas of pain, often in noninferiority studies against potent opioids. This review describes all randomized and recent nonrandomized studies of tapentadol in adults with cancer pain.
Tapentadol has been shown to be at least as effective as morphine and oxycodone in five randomized (two of which were multicenter and double-blind) and a range of nonrandomized trials, although caution is needed when interpreting these results. It is effective in both opioid-naive patients and those already taking opioids. By having a lower µ-opioid receptor binding affinity, it has fewer opioid-related toxicities such as constipation and nausea. A recent randomized trial comparing tapentadol to tapentadol plus duloxetine in patients with chemotherapy-induced peripheral neuropathy shows similar improvement in both groups in a range of pain relieving and quality of life measures, with similar adverse effects.
Tapentadol has been shown in a range of studies to be an effective analgesic and thus should be considered as an alternative to morphine and oxycodone, especially when opioid toxicities are an issue.
曲马多是新型镇痛药，对 μ 阿片受体具有激动作用，同时可抑制去甲肾上腺素再摄取。该药已广泛应用于多种疼痛领域，且常与强效阿片类药物进行非劣效性研究。本文描述了所有关于曲马多治疗成人癌痛的随机和近期非随机研究。
曲马多在 5 项随机（其中 2 项为多中心、双盲）和多项非随机研究中至少与吗啡和羟考酮等效，但在解释这些结果时应谨慎。该药对阿片类药物初治患者和已用阿片类药物的患者均有效。由于曲马多对 μ 阿片受体的亲和力较低，其相关的阿片类药物毒性（如便秘和恶心）较少。最近一项比较曲马多与曲马多加度洛西汀治疗化疗引起的周围神经痛的随机试验显示，两组在一系列止痛和生活质量指标上均有相似的改善，且不良反应相似。
多项研究表明曲马多是一种有效的镇痛药，因此可作为吗啡和羟考酮的替代药物，尤其是当存在阿片类药物毒性问题时。
