Tutak U, Doleys D M
Department of Anesthesiology and Pain Management Services, HealthSouth Medical Center, Birmingham, Ala, USA.
South Med J. 1996 Mar;89(3):295-300. doi: 10.1097/00007611-199603000-00007.
In this study, 26 patients (average age, 44.3 years) with chronic noncancer pain averaging 115 months' duration had implantation of an infusion pump with intrathecal catheter placement. In general, preservative-free morphine sulfate was used. Average follow-up was 23 months. Measurements of pain reduction, activity improvement, oral medication use, and overall satisfaction by patient, spouse, and clinic staff were obtained. Of the 26 patients, 20 noted a good or excellent outcome. Average daily dosage of intrathecal morphine increased over time by approximately sevenfold. Subjective pain levels decreased an average of 59%, and daily functioning increased 50%. No postoperative complications were noted, but 11 patients required additional surgery (9 for catheter complications). These data support chronic spinal opiate therapy as an option for safe and long-term management of noncancer pain.
在本研究中，26例慢性非癌性疼痛患者（平均年龄44.3岁，疼痛平均持续时间115个月）接受了植入式输注泵及鞘内导管置入术。一般使用无防腐剂的硫酸吗啡。平均随访时间为23个月。收集了患者、配偶及诊所工作人员对疼痛减轻、活动改善、口服药物使用情况及总体满意度的测量数据。26例患者中，20例结果良好或极佳。鞘内吗啡的平均日剂量随时间增加了约7倍。主观疼痛水平平均降低了59%，日常功能提高了50%。未观察到术后并发症，但11例患者需要再次手术（9例因导管并发症）。这些数据支持慢性脊髓阿片类药物治疗作为非癌性疼痛安全长期管理的一种选择。
