盐酸羟考酮控释片治疗老年癌痛体会

目的 观察盐酸羟考酮控释片(商品名:奥施康定),治疗老年恶性肿瘤患者中、重度疼痛的临床效果及不良反应,明确该药在治疗老年癌痛中的有效性及安全性.方法 2005年3月至2009年2月中、重度疼痛老年恶性肿瘤患者(年龄≥60岁)106例,给予盐酸羟考酮控释片镇痛治疗,初始剂量10 mg/12 h,正在用吗啡类镇痛药者,按照口服吗啡1/2剂量换算,根据疼痛情况调整剂量,直至患者无痛或基本无痛,每位患者至少治疗4周以上.同时进行疼痛强度、睡眠、食欲、疲乏、精神状态、日常生活、理解配合程度评分及不良反应观察.结果 盐酸羟考酮控释片在老年癌痛患者最小有效剂量为10 mg/d,每日剂量≥200 mg的23例(21.7%),100～180 mg/d的30例(28.2%),10～90 mg/d的53例(50.0%).疼痛缓解率为97.2%,不良反应主要表现为消化道反应(便秘、恶心和呕吐),便秘较常见,需要药物干预者26例(24.53%).结论 盐酸羟考酮控释片治疗老年中、重度癌性疼痛疗效显著,耐受性良好,不良反应较少,能很好地改善老年癌症患者的生活质量.     

盐酸羟考酮控释片治疗中晚期癌性疼痛病人的护理体会

中晚期癌症病人约70%伴随有疼痛症状,给病人的身心健康造成很大不良影响。疼痛成为中晚期癌症病人最迫切解决的问题之一。疼痛控制的好坏对于提升病人满意度有很重要的作用。盐酸羟考酮控释片治疗中晚期癌性疼痛病人有很好的疗效。现将我科2011年6月—2011年12月治疗的55例中晚期癌症病人的护理体会总结如下。     

盐酸羟考酮控释片治疗癌性疼痛的临床效果观察

目的:观察盐酸羟考酮控释片治疗癌性疼痛的临床效果.方法:回顾性分析34例癌症患者的临床资料,所有患者均伴有中度或重度疼痛,所有患者均口服盐酸羟考酮控释片进行治疗,统计镇痛效果及不良反应.结果:34例癌症患者经过治疗达到CR及PR标准者30例,CR+PR比例为88.24％.34例患者中出现便秘10例,头晕、恶心7例,呕吐2例,嗜睡2例,所有不良反应经过对症治疗后均有所好转.结论:针对癌性疼痛患者,盐酸羟考酮控释片镇痛效果好,安全性高,具有较高的临床应用价值.     

盐酸羟考酮控释片治疗中重度癌痛疗效观察

目的观察盐酸羟考酮控释片治疗中重度癌痛的疗效及不良反应。方法 56例中重度癌痛患者均给予盐酸羟考酮控释片治疗,初始剂量为10～20mg/次,1次/12h,口服,并依据患者疼痛缓解程度不同逐渐增加剂量至疼痛缓解,观察服药14d患者疼痛评分、疼痛缓解率及不良反应。结果患者治疗前、后疼痛评分分别为(7.59±1.33),(1.68±1.48)分,差异有统计学意义(P<0.01);治疗后疼痛轻度缓解5例(8.9%),中度缓解32例(57.1%),完全缓解19例(33.9%),疼痛缓解有效率为91.1%;治疗过程中发生便秘17例(30.3%),恶心呕吐8例(14.3%),腹胀7例(12.5%)、厌食8例(14.3%)、头晕3例(5.3%)、嗜睡8例(14.3%)、一过性排尿困难5例(8.9%)。结论盐酸羟考酮控释片个体化给药用于中重度癌痛镇痛效果满意,不良反应可耐受。     

盐酸羟考酮控释片治疗中重度骨转移癌痛36例临床观察

我院自2005年9月至2007年3月对36例中重度骨转移癌痛患者采用盐酸羟考酮控释片(奥施康定)控制疼痛,取得较好疗效,现报告如下。资料与方法1.一般资料36例均经ECT、MRI或CT检查证实骨转移的晚期癌症患者,均伴有中、重度疼痛。其中男性16例,女性20例,中位年龄58岁。原发病灶均经病     

盐酸羟考酮控释片治疗中重度癌痛的临床观察

目的观察盐酸羟考酮控释片（奥施康定）治疗中重度癌痛的疗效。方法选择52例中重度癌痛患者进行治疗，观察起效时间、治疗效果以及不良反应。结果盐酸羟考酮控释片治疗中重度癌痛起效快，平均起效时间为37min（25～65min），平均镇痛时间为10．8h（8～14h）。镇痛效果明显，总缓解率为96．2％。不良反应有便秘、恶心、呕吐、头晕、嗜睡、多汗和一过性排尿困难。结论盐酸羟考酮控释片可以安全用于中重度癌痛患者的止痛治疗。     

63例盐酸羟考酮控释片联合唑来磷酸盐治疗骨转移性癌痛的护理

晚期恶性肿瘤骨转移的发生率高达15%～70%。骨转移导致的持续疼痛及爆发痛,严重影响病人的生活质量,有些病人甚至产生自杀的念头[1]。药物治疗是控制慢性癌痛的主要方法[2]。其中盐酸羟考酮控释片联合双磷酸盐治疗能明显减轻骨转移性癌痛,缓解恶性肿瘤对骨质的破坏,降低病人发生病理性     

盐酸羟考酮控释片改善中重度癌性疼痛患者不良情绪状态的临床研究

目的:观察盐酸羟考酮控释片对中重度癌性疼痛(以下简称癌痛)患者的临床疗效和对不良情绪状态的影响.方法:2009年6月～2011年6月应用盐酸羟考酮控释片治疗82例晚期中重度癌痛患者,治疗期间记录患者疼痛评分,治疗前后进行抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)评分并记录不良反应.结果:疼痛缓解率为93.9％,82.9％的患者在首次用药后1h内疼痛减轻;治疗前后患者SDS、SAS评分降低,存在抑郁/焦虑状态比例下降.结论:盐酸羟考酮控释片具有较好的止痛效能,同时可部分改善中重度疼痛的晚期癌症患者轻、中度不良情绪.     

盐酸羟考酮控释片治疗癌痛不良反应的观察及护理

盐酸羟考酮(奥施康定)镇痛强度是吗啡的2倍,药效作用个体间差异较小,其口服生物利用度是常用阿片类药物中最高的,为吗啡2～3倍[1]。2004年3-11月,我科应用盐酸羟考酮控释片治疗中、重度癌痛患者22例,其目的为观察该药对中、重度癌性疼痛的止痛效果及不良反应。其中21例患者占90     

盐酸羟考酮控释片治疗晚期癌症疼痛的临床应用

目的:观察盐酸羟考酮控释片(奥施康定)治疗晚期癌症中、重度疼痛的临床效果、不良反应及患者生活质量的改善情况.方法:68例中、重度疼痛患者给予奥施康定镇痛治疗,初始剂量10ms/12h,正在用吗啡类镇痛药者,按照吗啡1/2剂量换算.根据疼痛情况调整剂量,直至患者无痛或基本无痛,每位患者至少治疗15d以上,同时进行疼痛强度、生活质量评分及不良反应观察.结果:奥施康定的最终滴定剂量为:≤30 mg/d的30例(44.1%),31～60 mg/d的16例(23.5%),61～120 mg/d的18例(26.5%),≥120 mg/d的4例(5.9%).总疼痛缓解率为95.6%,其中完全缓解27例(39.7%),明显缓解33例(48.5%),中度缓解5例(7.4%).患者生活质量明显提高,不良反应少且轻微.结论:盐酸羟考酮控释片治疗中、重度癌性疼痛疗效显著,不良反应较少,能显著改善癌症患者的生活质量.     

Controlled-release oxycodone for the management of pediatric postoperative pain

Studies addressing pain management after pediatric spinal fusion surgery have focused on the use of patient-controlled or epidural analgesia during the immediate postoperative period. Controlled-release (CR) analgesics have been found to be safe and effective in adults. The purpose of this study was to describe the use of oxycodone-CR in pediatric patients after the immediate postoperative period. A retrospective chart review of 62 postoperative spinal fusion patients (10-19 years) was conducted. The mean initial oxycodone-CR dose was 1.24 mg/kg/day. The mean ratio of conversion from parenteral morphine equivalents to oxycodone-CR was 1:1. Mean pain scores decreased from 4.2/10 to 3.7/10 with the transition to oxycodone-CR. Common side effects included dizziness, constipation, and nausea. Oxycodone-CR was used for an average of 13.3 days, which included an average wean time of 6 days. Results of this study demonstrate safe and effective use of oxycodone-CR in the pediatric spinal fusion population.     

盐酸羟考酮缓释片和盐酸吗啡片滴定治疗癌痛患者的有效性和安全性

目的分析盐酸羟考酮缓释片和盐酸吗啡片滴定治疗癌痛患者的有效性和安全性。方法选择2017年1月至2018年1月我科的64例癌痛患者为研究对象,采用随机数字法将其分为单药治疗组和联合治疗组,各32例。给予单药治疗组单用盐酸羟考酮缓释片治疗,给予联合治疗组盐酸羟考酮缓释片联合盐酸吗啡片滴定治疗。比较两组患者治疗前、后ECOG-PS评分、KPS评分、SF-MPQ评分、ES评分以及不良反应发生情况。结果治疗后,两组患者的ECOG-PS、SF-MPQ及ES评分均较治疗前降低,KPS评分均较治疗前升高,且联合治疗组均优于单药治疗组(P<0.05)。联合治疗组的恶心、呕吐、口干、便秘、厌食、头晕、嗜睡乏力、皮肤过敏、尿潴留发生率均明显低于单药治疗组(P<0.05)。结论相比单用盐酸羟考酮缓释片治疗,应用盐酸羟考酮缓释片联合盐酸吗啡片滴定治疗能够明显缓解癌痛症状,且不良反应发生率较低,值得临床推广应用。     

Controlled-release oxycodone for the treatment of bortezomib-induced neuropathic pain in patients with multiple myeloma

Purpose

Bortezomib, a proteasome inhibitor drug very effective against multiple myeloma, may induce the so-called bortezomib-induced peripheral neuropathy (BIPN), hardly manageable with common analgesic drugs. This study assessed the effectiveness of controlled-release (CR) oral oxycodone in controlling pain and its interference on daily functions of patients with hematologic malignancies affected by BIPN.

Methods

Forty-six patients (median age, 62 years) affected by myeloma and lymphoma, complaining of BIPN-related pain of moderate-to-severe intensity and unresponsive to previous analgesic treatments, were treated with CR oxycodone. The intensity of continuous and brief pain (BP) along with interference of pain with the common daily dimensions of feeling and function were evaluated by using an 11-point numerical rating scale (NRS); a global patient evaluation of efficacy was also performed.

Results

The daily average dose of CR oxycodone administered was 28.46 mg (range, 20–80 mg). The pain intensity decreased from a mean NRS value of 7.6 at baseline to 1.3 on day 14. The frequency of BP was reduced from 61 to 47 % of patients and its intensity from 7.4 to 3.1 NRS score. A similar trend to decreasing values was observed for all the daily life functions. Slight- or mild-intensity side effects were observed in 23 patients (51 %). At the end of the study, 75 % of patients found the treatment effective or very effective.

Conclusion

CR oxycodone for relief of BIPN-related pain was effective and well tolerated. The pain control significantly improved also the quality of the daily life functions, which are usually compromised in these suffering patients.     

Morphine and oxycodone hydrochloride in the management of cancer pain

In a double-blind crossover study, morphine and oxycodone hydrochloride were administered to 20 patients who were experiencing severe cancer pain. The peroral doses were determined on the basis of patient-controlled intravenous titration. The assumed oral bioavailability ratios were 44% (group 1, first 10 patients) and 33% (group 2, last 10 patients) for morphine and 66% (group 1) and 50% (group 2) for oxycodone hydrochloride, respectively. However, the patients were able to readjust their oral dosings. Equal analgesia was achieved with both drugs, but the intravenous dose of oxycodone hydrochloride needed was 30% higher than that of morphine. The median calculated oral/intravenous ratios giving comparable analgesia were 0.31 for morphine and 0.70 for oxycodone hydrochloride. Morphine caused more nausea than oxycodone hydrochloride and hallucinations occurred only during morphine treatment. Otherwise, there were no major differences in the side effects between these two opioids.     

Controlled-release oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy

BACKGROUND: Painful neuropathy is one of the most common long-term complications of diabetes mellitus and often proves difficult to relieve.METHODS: Patients with diabetic neuropathy with moderate or greater pain for at least 3 months, were evaluated for efficacy, safety and health-related quality of life (QOL) while receiving controlled-release (CR) oxycodone (OxyContin) or active placebo. Patients underwent washout from all opioids 2-7 days before randomization to 10 mg CR oxycodone or active placebo (0.25 mg benztropine) q12h. The dose was increased, approximately weekly, to a maximum of 40 mg q12h CR oxycodone or 1 mg q12h benztropine, with crossover to the alternate treatment after a maximum of 4 weeks. Acetaminophen, 325-650 mg q4-6h prn was provided as rescue.RESULTS: Thirty-six patients were evaluable for efficacy (21 men, 15 women, mean age 63.0+/-9.4 years). CR oxycodone resulted in significantly lower (P=0.0001) mean daily pain (21.8+/-20.7 vs. 48.6+/-26.6 mm VAS), steady pain (23.5+/-23.0 vs. 47.6+/-30.7 mm VAS), brief pain (21.8+/-23.5 vs. 46.7+/-30.8 mm VAS), skin pain (14.3+/-20.4 vs. 43.2+/-31.3 mm VAS), and total pain and disability (16.8+/-15.6 vs. 25.2+/-16.7; P=0.004). Scores from 6 of the 8 SF-36 domains and both summary scales, Standardized Physical Component (P=0.0002) and Standardized Mental Component (P=0.0338) were significantly better during CR oxycodone treatment. The number needed to treat to obtain one patient with at least 50% pain relief is 2.6 and clinical effectiveness scores favoured treatment with CR oxycodone over placebo (P=0.0001).CONCLUSION: CR oxycodone is effective and safe for the management of painful diabetic neuropathy and improves QOL.     

盐酸羟考酮缓释片治疗中重度癌痛临床观察

目的观察盐酸羟考酮缓释片治疗中重度癌痛的疗效、不良反应及对患者生活质量改善情况。方法120例中重度癌痛患者,均口服盐酸羟考酮缓释片,初始剂量为10～20rag／次,1次／12h,并根据疼痛缓解程度调整剂量至理想镇痛。用药14d后观察患者疼痛数字评分法（numericalratingscale,NRS）评分、疼痛缓解率、生活质量改善及不良反应发生情况。结果治疗后NRS评分（1．46±1．13）低于治疗前（6．37±1．63）（P〈O．05）;治疗后疼痛完全缓解64例,部分缓解52例,疼痛总缓解率为96．7％;治疗后生活质量评分较治疗前增高（P〈O．05）;不良反应轻。结论盐酸羟考酮缓释片治疗中重度癌痛效果满意,可改善患者生活质量。