Belmans L, Van Buyten J P, Vanduffel L, Vueghs P, Adriaensen H
Department of anesthesiology and pain management, A.Z. Maria Middelares, St. Niklaas, Belgium.
Acta Anaesthesiol Belg. 1997;48(2):93-7.
Spinally administered opioids must be a last step in the therapeutical arsenal of chronic benigne pain. It is an invasive technique not free from adverse effects. Two chronic pain patients received an implantable Synchromed pump for treatment with spinal opiates after a trial period of resp. 3.5 and 5.5 months. Due to a misprogrammation (both on the same day) they received very high doses of spinal opiates. This caused relatively few side effects, which did not seem to require immediate treatment. A short time development of tolerance to life threatening side-effects has been proven by this accidental administration of high-dose intraspinal opiates. It is critical that care providers are knowledgeable and well-trained about implantable infusion systems. Programmation and refills must always be performed with care.
椎管内给予阿片类药物必须是慢性良性疼痛治疗手段中的最后一步。这是一种有不良反应风险的侵入性技术。两名慢性疼痛患者在分别经过3.5个月和5.5个月的试验期后，接受了可植入式Synchromed泵以进行椎管内阿片类药物治疗。由于编程错误（同一天发生在两人身上），他们接受了非常高剂量的椎管内阿片类药物。这导致了相对较少的副作用，似乎不需要立即治疗。这种高剂量椎管内阿片类药物的意外给药已证明会在短时间内产生对危及生命副作用的耐受性。护理人员对可植入输液系统有充分的了解并接受良好的培训至关重要。编程和补充药物时必须始终小心谨慎。
