Kim Minsoo, Park Sun Kyung, Kim Woong Mo, Kim Eunsoo, Kim Hyuckgoo, Park Jun-Mo, Choi Seong-Soo, Choi Eun Joo
Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea.
Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, Korea.
Korean J Pain. 2024 Apr 1;37(2):119-131. doi: 10.3344/kjp.24022.
There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.
慢性非癌性疼痛患者长期使用阿片类药物治疗的安全性问题日益受到关注。2017年，韩国疼痛学会（KPS）制定了慢性非癌性疼痛阿片类药物处方指南，以指导医生有效且安全地开具阿片类药物。自那时起，已有研究提供了关于慢性非癌性疼痛阿片类药物治疗的最新数据，并聚焦于初始给药方案、重新评估随访、考虑风险效益比的推荐剂量阈值、逐渐减量和停药的减药方案、不良反应以及因不当应用先前指南而产生的意外问题。在此，我们基于全面的文献综述以及韩国疼痛学会临终关怀与姑息治疗委员会相关专家讨论后达成的共识，对先前的韩国疼痛学会指南进行了更新。这些指南可能有助于医生在成人门诊环境中为慢性非癌性疼痛开具阿片类药物，但不应被视为一成不变的标准。主治医师的临床判断和以患者为中心的决策应始终被置于优先地位。
