与持续稳定的阿片类药物治疗慢性非癌症疼痛相比,阿片类药物缓慢逐渐减少:双盲随机对照试验
Benjamin Lai1, Brandon Hidaka2, Mohammad Aziz3
1Department of Family Medicine, Mayo Clinic, Rochester, Minnesota. ORCID: https://orcid.org/0000-0002-6467-6179.
Journal of opioid management
|March 3, 2026
概括
慢性阿片类药物治疗 (COT) 的逐渐停止不会影响慢性非癌症疼痛患者的生活质量或抑郁症. 然而,逐渐减少阿片类药物与焦虑症状的轻微增加有关.
科学领域:
- 疼痛管理 疼痛管理
- 临床试验 临床试验
- 在阿片类药物治疗中使用阿片类药物
背景情况:
- 慢性阿片类药物治疗 (COT) 广泛用于非癌症疼痛.
- 研究停止COT的安全和有效方法至关重要.
- 有限的研究存在于缓慢的阿片类药物逐渐减少对患者福祉的影响.
研究的目的:
- 为了确定慢性阿片类药物治疗 (COT) 的逐渐停止是否会影响生活质量 (QOL),抑郁和焦虑.
- 评估缓慢阿片类药物逐渐减少协议的可行性和结果.
- 为更大规模的阿片类药物戒断研究提供数据.
主要方法:
- 在十个初级保健诊所进行了一项双盲随机对照试验.
- 对于慢性非癌症疼痛稳定COT的成年人被随机分配到缓慢逐渐缩小或继续治疗.
- 在12个月的多个时间点评估生活质量,抑郁和焦虑.
主要成果:
- 招募了18名患者,他们都使用了特拉马多尔或可.
- 在逐渐减少和持续组之间没有观察到生活质量或抑郁症状的显著差异.
- 接受慢慢降低阿片类药物的组报告了统计学上显著增加的焦虑症状 (p = 0.04).
结论:
- 慢慢逐渐减少的慢性阿片类药物治疗似乎是慢性非癌症疼痛患者的可行策略.
- 通过缓慢的逐渐减少停止服用阿片类药物并没有对生活质量或抑郁症产生负面影响.
- 焦虑的轻微增加需要在更大的队列中进一步调查.
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