癌性疼痛患者从吗啡向芬太尼持续注入转换的换算比例研究

目的：探讨从吗啡向芬太尼持续注入转换的适当换算比例。方法：通过20例癌性疼痛患者的回顾性临床调查,对疼痛程度、药物不良反应及治疗满意度进行评价。结果：本组转换后1周内稳定(转换前后疼痛强度无明显变化)(Good组)的有17例,不稳定(Poor组)的有3例。芬太尼注射剂和吗啡有同等的镇痛效果；转换后能够减轻副作用、提高满意度。结论：推荐从低剂量吗啡向芬太尼注射剂转换的换算比例是72∶1,并且推测从非低用量吗啡向芬太尼注射剂转换的换算比例小于72∶1有可能达到稳定。但不可能确定从吗啡向芬太尼持续注入转换的具体换算比例,应考虑转换前吗啡用量,再行确定转换的具体比例。

Equipotent ratio for conversion of morphine to continuous infusion of fentanyl in patients with cancer pain

Objective:To investigate the proper equipotent ratio for conversion of morphine to continuous infusion of fentanyl in patients who suffer from cancer pain.Methods:A retrospective study was performed on 20 patients with cancer pain in Shizuoka Cancer Center from 2002 Sep to 2003 Nov.Pain intensity,adverse reaction,and satisfaction index of patients were evaluated. Results:The pain intensity was stable before and after conversion in 17 patients within 1 week after conversion indicating good pain-control.It was unstable in 3 patients after conversion suggesting poor pain-control.Fentanyl injection had equipotenl pain- relieving effects with morphine.Conversion of morphine to fentanyl injection could alleviate side effects and increase the satisfac tion index of patients.Conclusions:An equipotent ratio for conversion of low dose morphine to fentanyl injection was established as 72:1,and for non low dose morphine a ratio less than 72:1 was proposed to get stable pain-relieving effect.But the equipo- tent ratio for conversion of morphine to continuous perfusion of fentanyl could not be determined.We must consider the morphine dosage before confirmation of the equipotent ratio.