Müller H, Börner U, Stoyanov M, Gleumes L, Hempelmann G
Anasth Intensivther Notfallmed. 1981 Oct;16(5):251-7.
In 75 patients epidural opiates were applied for relief of chronic cancer pain. In order to avoid local infection during long-term therapy part of the catheter was placed subcutaneously. Different opiates were used separately or in combination with local anaesthetics to define the degree and duration of pain relief after epidural opiate application. Haemodynamic and respiratory parameters, changes in lower extremity blood supply and other side-effects were recorded during epidural pain therapy. Epidural opiate application cause a long-lasting reduction of pain, which may become restricted during long-term or repeated use, especially after a period of systemic opiate therapy. Side-effects, for example slight respiratory depression in the first hour after injection, indicate an initial phase of resorption beeing followed by a long-lasting reduction of pain without attendant symptoms. Keeping in mind certain precautions epidural opiate therapy is superior to systemic opiate application.
75例患者采用硬膜外给予阿片类药物缓解慢性癌痛。为避免长期治疗期间发生局部感染,部分导管置于皮下。单独使用不同的阿片类药物或与局部麻醉药联合使用,以确定硬膜外给予阿片类药物后疼痛缓解的程度和持续时间。在硬膜外疼痛治疗期间记录血流动力学和呼吸参数、下肢血液供应变化及其他副作用。硬膜外给予阿片类药物可使疼痛长期减轻,但在长期或重复使用期间,尤其是在经过一段时间的全身阿片类药物治疗后,这种减轻可能会受到限制。副作用,如注射后第一小时出现的轻微呼吸抑制,表明有一个初始吸收阶段,随后是疼痛的长期减轻且无伴随症状。牢记某些预防措施,硬膜外阿片类药物治疗优于全身应用阿片类药物。