Buchser E, Moret V, Chédel E
Faculté de médecine, Service d'anesthésiologie du CHUV, Lausanne.
Rev Med Suisse Romande. 1993 Feb;113(2):89-92.
Spinal administration of morphine and other opiates has been used in clinical practice since many years, particularly in the outpatient management of cancer pain patients. The rationale and the safety of chronic spinal opiate administration is well established and not questioned anymore. However, the indications to use these therapies remain unclear, essentially because no controlled studies have ever shown the advantages of these treatments. Nevertheless, there is no doubt that some patients are unable to get adequate pain relief with conventional oral opiate administration, and will significantly benefit from the change to the spinal route. This raises technological and financial issues, as well as management problems related to the home care system. The choices that have to be made should include the home physician, the home care nursing team as well as the hospital based pain management team. This short overview will deal with some of these aspects.
多年来，吗啡和其他阿片类药物的脊髓给药已应用于临床实践，尤其是在癌症疼痛患者的门诊管理中。长期脊髓阿片类药物给药的基本原理和安全性已得到充分确立，不再受到质疑。然而，使用这些疗法的适应症仍不明确，主要是因为没有对照研究表明这些治疗方法的优势。尽管如此，毫无疑问，一些患者无法通过传统的口服阿片类药物给药获得足够的疼痛缓解，而改为脊髓给药途径将显著受益。这引发了技术和财务问题，以及与家庭护理系统相关的管理问题。必须做出的选择应包括家庭医生、家庭护理团队以及医院的疼痛管理团队。本简要概述将涉及其中的一些方面。
