Ricci V, Dalpane A, Lolli E
Servizio di Anestesia e Rianimazione, Presidio Ospedaliero - Lugo (Ravenna), Azienda unità Sanitaria Locale, Ravenna.
Minerva Med. 1995 Oct;86(10):409-14.
The authors in this study, after a short survey of the most important therapeutic techniques for cancer pain, report their results in the treatment of 18 patients suffering from incurable disease. It was impossible to dismiss them from hospital care on account of a painful symptomatology not controllable by oral morphine or owing to excessive collateral morphinic consequences. The analgetic technique employed was continuous intrathecal infusion of morphine, clonidine, droperidol and, in 10 cases, bupivacaine. Drug delivery systems, totally internalized, except infusion pump, were always utilized. Adequate pain relief was obtained, within - 5 days, in all the patients. Family membres, in the same period, learnt the infusion circuit action. At this point the patients were dismissed and treated with home care. The average time of assistance was 140 days, and very moderate variations in posology were necessary. Hospital reentrance, really little numerous, happened only when no member of palliative care service was present. Reasons were no bodily pain, but the total suffering of cancer disease. No complication nor collateral consequences were never found.
本研究的作者在简要调查了癌症疼痛最重要的治疗技术后，报告了他们对18名患有不治之症患者的治疗结果。由于口服吗啡无法控制疼痛症状或因吗啡副作用过大，无法将他们从医院护理中撤离。所采用的镇痛技术是持续鞘内注射吗啡、可乐定、氟哌利多，其中10例患者还注射了布比卡因。除输液泵外，始终使用完全植入体内的给药系统。所有患者在5天内均获得了充分的疼痛缓解。在此期间，患者家属了解了输液回路的操作。此时，患者出院并接受家庭护理。平均护理时间为140天，且剂量调整非常适度。只有在姑息治疗服务人员均不在场时，才会出现很少的再次入院情况。原因不是身体疼痛，而是癌症疾病带来的全面痛苦。从未发现任何并发症或副作用。
