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鼻内胺在门诊环境下治疗慢性癌症相关疼痛:双刃剑
Joseph Nalbone1, Ari Levine2, Justine W Welsh3
1Department of Anesthesiology, Emory University, Atlanta, GA, USA.
Pain management
|December 9, 2025
概括
自用注射鼻内胺可以减少癌症疼痛和阿片类药物使用. 然而,疲劳和认知减缓等不良影响限制了其长期使用,需要采取风险减轻策略.
科学领域:
- 在瘤学瘤学.
- 疼痛医学 医学 疼痛医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 与癌症相关的疼痛影响着数百万人,而阿片类药物往往无法提供足够的缓解或引起显著的副作用.
- 高剂量的阿片类药物是癌症疼痛的标准,但可以损害生活质量 (QoL),并且对40%的患者无效.
- 鼻内胺呈现出一种与阿片类药物不同的副作用概况的替代止痛药选择,允许更容易的自我管理.
研究的目的:
- 为了评估自给自取的鼻内赛血胺对癌症患者不良反应,疼痛强度和QOL的影响.
- 评估内胺在减少阿片类药物消费方面的疗效.
- 在息护理环境中记录鼻内胺的耐受性和安全性.
主要方法:
- 一个涉及三名患有癌症相关疼痛的患者的病例系列,这些患者接受了鼻腔内赛米基胺治疗.
- 数据收集包括疼痛评分,阿片类药物消费 (口服吗啡等价物 - OME) 和临床接触期间不良事件监测.
- 患者在高等学术中心接受了息治疗和疼痛医学专家的护理.
主要成果:
- 这三名患者都经历了镇痛效益,阿片类药物 (OME) 减少高达90%.
- 尽管缓解了疼痛,但所有患者都出现了不良反应,包括疲劳,认知减慢和分离.
- 这些不良反应导致所有病例中断了胺治疗,治疗持续时间从1到8个月不等.
结论:
- 鼻内胺显示出降低癌症疼痛管理中的阿片类药物需求的潜力.
- 然而,副作用的发生可能会显著限制治疗的耐受性和持续时间.
- 需要进一步的研究来识别高风险出现不良反应的患者,并制定降低风险的策略.
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