Conigliaro D A
Center for Pain Medicine, Florida Medical Plaza in Orlando, USA.
J Fla Med Assoc. 1996 Dec;83(10):708-11.
In summary, opioid use for chronic non-malignant pain is justified in a select group of patients who do not respond to a variety of other pain treatment modalities. Proper trials of the analgesics given "by the clock" in appropriate dosages with attention to potential side effects and proper documentation is important. Efficacy should be monitored by improvement in function and symptomatology. Undertreatment for fear of addiction or legal consequences should be avoided. Specialized pain clinics may be utilized for consultation regarding the long-term use of opioids or for more advanced pain management strategies, possibly including the use of intraspinal opioid delivery systems.
总之，对于一组对多种其他疼痛治疗方式无反应的特定患者，使用阿片类药物治疗慢性非恶性疼痛是合理的。以适当剂量“按时”给予镇痛药，并注意潜在副作用和妥善记录，进行适当的试验很重要。应通过功能和症状的改善来监测疗效。应避免因担心成瘾或法律后果而治疗不足。对于阿片类药物的长期使用咨询或更先进的疼痛管理策略（可能包括使用脊髓内阿片类药物输送系统），可利用专业疼痛诊所。
