奥施康定治疗200例中重度癌痛临床体会

目的:观察奥施康定治疗中重度癌痛疗效、毒副反应,总结临床体会。方法:应用奥施康定治疗中重度癌痛患者,回顾性总结有疼痛评分记录及疗效、毒副反应记录的门诊或住院用药患者的临床用药体会。结果:有200例患者纳入本研究。奥施康定使用剂量为5mg q12h至240mg q12h,1例患者用80mg q8h方能持续有效止痛,疼痛控制总有效率为90.0%。应用奥施康定配合速效吗啡片达到良好滴定效果;毒副反应主要为便秘、头晕、恶心、呕吐、尿储留,也有出现皮疹、瘙痒,过度镇静、呼吸抑制各2例;预防性用药及用药前与患者充分沟通能减少或减轻不良反应;尽早、适当应用辅助药可以增加止痛疗效,减少阿片类药物用量;随着用药时间延长,即使药物剂量加大,不良反应发生率逐渐降低。结论:奥施康定是中重度癌痛患者良好选择,应用过程中要注意具体细节,恰当配合止痛辅助药,尽量减少不良反应,特别是严重不良反应的发生。

Clinical Experience of 200 Cases of Moderate and Severe Cancer Pain Treated by Oxycontin

Objective: The aim of this study is to observe the efficacy and toxic side effects,meanwhile summarize the clinical experience.Method: We used oxycontin to treat moderate and severe cancer pain,retrospectively summarize the clinical experience of patients(outpatint or inpatient) with pain record score or data about efficacy and toxic side effects.Result: Two hundreds patients were enrolled into this study.The dosage used was 5 mg q12-240 mg q24h.One patient was administrated by 80mg q8h in order to keep sustainable and effective analgesic action.The overall response rate was 90.0%.Oxycontin in combination with available morphine tablets could reach good titrating effect.The main tixic and side effects were constipation,dizziness,nausea and vomiting,retention of urine.skin rash,Pruritus,excessive sedation and respiratory depression rarely occurred(all n=2).Prophylactic use of drugs and full communication with patients before treatment could reduce or alleviate the adverse events.Appropriate application of adjuvant drugs could increase the analgesic effect and reduce the dosage of opioids.With prolonged treatment,even if the drug doses were increased,the incidence of adverse reactions was also decreased.Conclusions: Oxycontin is a good choice for patient with moderate and severe cancer pain.More attention should be payed to details during the application process: appropriately use analgesic adjuvant drugs;minimize the adverse reactions,especially the occurrence of serious adverse reactions.