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[通过脊髓导管治疗重度癌痛]

[Treatment of severe cancer pain via spinal catheters].

作者信息

Andersen J S, Markers P I, Valentin N

机构信息

Anaestesiologisk afdeling, Amtssygehuset i Gentofte.

出版信息

Ugeskr Laeger. 1996 Nov 11;158(46):6613-6.

PMID:8966828
Abstract

Twenty-seven patients with pain from non-curable cancer, who did not respond to systemic pain treatment with opioids and coanalgesics without the occurrence of unacceptable side effects, were treated with intrathecal infusions. Two patients were treated satisfactorily with morphine alone, while the remainder were given a mixture of morphine and bupivacaine. Complete or good pain relief was reported by 23 patients and some relief by three patients. The poorest results were obtained in the patients who died within the first week of intrathecal treatment. Post-spinal headache occurred in five patients and temporary paraesthesia or motor deficits in five. No serious complications were recorded. The treatment of severe cancer pain by intrathecal infusion of morphine and bupivacaine seems to be a promising method. As the adjustment of doses takes some days, and as the main complication, post-spinal headache, occurs early in the course, the method is most suitable for use in patients expected to survive for at least a couple of weeks.

摘要

27名患有无法治愈癌症且伴有疼痛的患者,在接受阿片类药物和辅助镇痛药的全身疼痛治疗且未出现不可接受的副作用但仍无反应后,接受了鞘内输注治疗。2名患者仅使用吗啡治疗效果满意,其余患者则给予吗啡和布比卡因的混合药物。23名患者报告疼痛完全或明显缓解,3名患者有部分缓解。鞘内治疗第一周内死亡的患者治疗效果最差。5名患者出现了脊麻后头痛,5名患者出现了暂时性感觉异常或运动功能障碍。未记录到严重并发症。鞘内输注吗啡和布比卡因治疗重度癌痛似乎是一种有前景的方法。由于剂量调整需要几天时间,且主要并发症脊麻后头痛在病程早期就会出现,因此该方法最适合用于预期至少能存活几周的患者。

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