Watanabe S, Pereira J, Hanson J, Bruera E
Grey Nuns Community Health Centre, Cross Cancer Institute, Edmonton, Alberta, Canada.
J Pain Symptom Manage. 1998 Nov;16(5):323-6. doi: 10.1016/s0885-3924(98)00095-5.
Twenty-two patients who received fentanyl by continuous subcutaneous infusion for treatment of cancer pain were evaluated retrospectively. No local toxicities were noted. Five patients were switched from transdermal fentanyl due to uncontrolled pain; three achieved stability, accompanied by improvement in visual analogue scores for pain. Seventeen patients were switched from other opioids due to toxicity; 10 achieved stability, with documented improvement in toxicity in seven. The median dose ratio of opioid prior to switchover (mg/day) to fentanyl at stabilization (mg/day) was 85.4 (range 65-112.5) for morphine and 23.0 (range 10.7-29.7) for hydromorphone. Of six stable patients switched from subcutaneous to transdermal fentanyl, four maintained stability. We conclude that fentanyl by continuous subcutaneous infusion is a useful alternative for cancer patients who experience uncontrolled pain while receiving transdermal fentanyl or who experience toxicity on other opioids.
对22例通过皮下持续输注芬太尼治疗癌痛的患者进行了回顾性评估。未观察到局部毒性。5例患者因疼痛控制不佳从透皮芬太尼转换治疗；3例病情稳定，同时视觉模拟疼痛评分有所改善。17例患者因毒性反应从其他阿片类药物转换治疗；10例病情稳定，其中7例有记录显示毒性反应有所改善。转换前阿片类药物（mg/天）与稳定期芬太尼（mg/天）的剂量中位数比值，吗啡为85.4（范围65 - 112.5），氢吗啡酮为23.0（范围10.7 - 29.7）。6例从皮下芬太尼转换为透皮芬太尼的稳定患者中，4例维持稳定。我们得出结论，对于在接受透皮芬太尼时疼痛控制不佳或对其他阿片类药物有毒性反应的癌症患者，皮下持续输注芬太尼是一种有用的替代方法。
