Noyes R
Psychosom Med. 1981 Feb;43(1):57-70. doi: 10.1097/00006842-198102000-00007.
Undertreatment of cancer pain results not only from the limited expectations of patients but also from the inadequate knowledge of many physicians. Successful management of this pain requires awareness of the importance of emotional factors and detailed knowledge of various treatment options. When indicated, analgesic drugs should be administered according to a regular schedule and in sufficient dose to prevent the emergence of pain. Psychological techniques including supportive psychotherapy, relaxation training, hypnosis, and the hospice milieu may contribute to a comprehensive approach to pain. Likewise, psychotropic drugs including phenothiazines and tricyclic antidepressants may be useful adjuncts when administered along with appropriate analgesic medication. Although most pain associated with advanced cancer may be relieved by currently available methods, research in this area is urgently needed.
癌症疼痛治疗不足不仅源于患者期望有限,还源于许多医生知识欠缺。成功管理这种疼痛需要认识到情感因素的重要性以及对各种治疗选择的详细了解。如有必要,应按常规时间表并给予足够剂量的镇痛药以防止疼痛出现。心理技术,包括支持性心理治疗、放松训练、催眠和临终关怀环境,可能有助于采取全面的疼痛治疗方法。同样,吩噻嗪类和三环类抗抑郁药等精神药物与适当的镇痛药物一起使用时可能是有用的辅助药物。虽然目前可用的方法可以缓解大多数与晚期癌症相关的疼痛,但该领域的研究仍迫切需要。