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长期疼痛的吗啡反应:双盲随机交叉研究与患者控制的止痛药
Lancet (London, England)
|June 6, 1992
概括
对阿片类药物的慢性疼痛反应有所不同. 患者控制的止痛疗法 (PCA) 有效地评估了吗啡的有效性,区分了针对量身定制的治疗策略的痛感和神经病痛反应.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学 是一个学科.
- 临床研究 临床研究
背景情况:
- 长期疼痛中的阿片类药物反应受到争论,可感性疼痛通常被认为是响应性疼痛,而神经病变性疼痛则不那么响应性.
- 评估不同类型的慢性疼痛的阿片类药物疗效需要可靠的方法.
研究的目的:
- 为了评估患者控制止痛疗法 (PCA) 在评估慢性疼痛中阿片类药物反应的有效性.
- 区分对吗啡的感觉性和神经性疼痛反应.
- 为了确定心情是否影响神经病痛中止痛反应.
主要方法:
- 一项双盲随机交叉研究,涉及10名慢性疼痛患者,通过PCA在两种度 (10和30毫克/毫升) 中使用吗啡.
- 护士观察员对镇痛,情绪和不良影响的评估.
- 在研究之前,临床判断将疼痛分类为感觉或神经病.
主要成果:
- 七名患者表现出良好的止痛反应 (>70毫米止痛),两名患者反应不佳 (<30毫米),一名患者反应中度.
- 较高的吗啡度 (30毫克/毫升) 一般导致更大,更快的疼痛缓解.
- 患有 nociceptive 疼痛的患者表现出良好的反应,而大约一半患有神经性疼痛的患者反应良好.
结论:
- PCA是一种有效的工具,用于评估慢性疼痛中阿片类止痛药反应的一致性.
- 一致的反应指导了继续或更高剂量的阿片类药物治疗的决定.
- 不一致的反应表明需要替代疼痛管理策略.
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