Lazorthes Y R, Sallerin B A, Verdié J C
Department of Neurosurgery, Faculty of Pharmaceutical Sciences, Paul Sabatier University, Toulouse, France.
Neurosurgery. 1995 Sep;37(3):422-8; discussion 428-9. doi: 10.1227/00006123-199509000-00009.
Intracerebroventricular morphine analgesic for the treatment of cancer pain was administered, using implanted access ports, in 82 patients from 1984 to January 1994. All of the patients who were selected for treatment were no longer responsive and had developed drug side effects to oral or parenteral opiates in varying doses (60-400 mg/d). The mean follow-up was 66 days (range, 12-443 d) for this series of 82 patients. The effective control of pain was achieved in nearly all of the patients, with only two failures. During the treatment, the daily morphine doses were moderately increased. The initial doses of morphine were a mean of 0.30 mg (range, 0.10-2 mg), and the final doses were a mean of 2.5 mg (range, 0.10-60 mg). The results show that the ratio of the terminal dose to the initial dose increased more rapidly for patients who had a follow-up of over 60 days. However, the increase seems to have been because of the progress of the disease rather than because of drug tolerance.
1984年至1994年1月，82例患者通过植入式接入端口接受脑室内注射吗啡治疗癌症疼痛。所有入选治疗的患者均对不同剂量（60 - 400mg/d）的口服或胃肠外阿片类药物不再有反应，并出现了药物副作用。这组82例患者的平均随访时间为66天（范围12 - 443天）。几乎所有患者的疼痛都得到了有效控制，仅有两例失败。治疗期间，吗啡的每日剂量适度增加。吗啡的初始剂量平均为0.30mg（范围0.10 - 2mg），最终剂量平均为2.5mg（范围0.10 - 60mg）。结果显示，随访超过60天的患者，终末剂量与初始剂量的比值上升得更快。然而，这种增加似乎是由于疾病进展而非药物耐受性所致。
