まとめ
緩和ケアにおける症状制御のためのオピオイドの使用は,寿命を短縮しません. 人生の終わりにオピオイドの投与量を増加させた患者は,短期間生存を経験せず,早死に関する懸念を否定しました.
科学分野:
- 緩和ケア医療 緩和ケア医療 緩和ケア医療
- 疼痛管理 疼痛管理
- 終末期介護は終末期介護である.
背景:
- 症状管理中に潜在的に寿命を短くするオピオイドの使用に関して,公衆と専門家の懸念が存在しています.
- 二重効果の教義は,症状制御のためのオピオイド投与を正当化するためにしばしば提唱されます.
研究 の 目的:
- 人生最後の1週間におけるオピオイド使用パターンを調査する.
- オピオイドの投与または投与量が,緩和ケア患者のインパクト生存時間を増加させるかどうかを判断する.
主な方法:
- オピオイド使用パターンの遡及的分析.
- 緩和ケアユニットに入院した連続した238人の患者を含む.
- 過去24時間のオピオイド用量の検査と終末期における用量調整.
主要な成果:
- 生後24時間のオピオイド用薬の投与量の中央値は低かった (26.4 mg).
- 終末期にオピオイドの投与量を増加させた患者は,より短い生存期間を示さなかった.
- オピオイドの投与量を増加させたグループと,増加させなかったグループの間では,統計的に有意な生存差は観察されなかった.
結論:
- 緩和ケアにおける症状制御のためのオピオイドの使用は,生存期間が短縮されたことと関連していません.
- 生命の終わりの症状管理のためにオピオイドの使用を正当化するために,二重効果の教義は必要ないかもしれません.
- 発見は,終末期疾患の苦しみを軽減するために,オピオイドの安全で倫理的な使用を支持しています.
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