苯二氮平衍生物及其相關藥物在末期疼痛控制的角色

The Role of Benzodiazepines and Related Drugs in Pain Control for Terminal Patients

姚嘉昌(Chia-Chan Yao) ； 王牧羣(Mu-Cyun Wang) ； 吳中興(Chung-Shing Wu) ； 施議強(I-Chang Shy)

《安寧療護雜誌》 13卷2期 (2008/05) Pp. 212-218

https://doi.org/10.6537/TJHPC.2008.13(2).6

摘要

苯二氮平衍生物是最常被使用的鎮靜安眠藥，在安寧療護的臨床應用也很普遍，如應用於治療末期疾病相關的焦慮、失眠、喘息、疼痛。作用於相同接受體的非苯二氮平衍生物類的安眠藥如zolpidem，主要用於失眠的治療，雖然此類藥物高劑量下可能有輕微的止痛效果，但高劑量可能伴隨的副作用限制了其在疼痛控制的應用。目前並不建議將苯二氮平衍生物及其相關藥物用於末期病人疼痛控制的主要治療，除非疼痛合併焦慮症、激動情緒或失眠，或是明顯爲神經痛，才考慮將苯二氮平衍生物列爲輔助藥物的考量之一。苯二氮平衍生物及其相關藥物在末期病人止痛的角色仍非常有限，需要進一步的實驗和研究來證實。

關鍵字

苯二氮平衍生物 ； 鎮靜安眠藥 ； 安寧緩和照護 ； 疼痛

並列摘要

Benzodiazepines (BDZ) are the most common sedative-hypnotics currently used. Their application in palliative and hospice care is also favorable, with examples like the treatment of anxiety disorders, insomnia, breathlessness, and pain associated with terminal illness. Non-benzodiazepine hypnotics like zolpidem target on the same category of receptors with main therapeutic function of managing insomnia. Despite their possibly mild degree of antinociceptive effect in high dose, the accompanying side effects neutralize their advantages and therefore limit their clinical application to pain control. It is not suggested to prescribe zolpidem for pain relief in terminally ill patients, and so do benzodiazepines unless the pain is complicated by anxiety, agitation, or insomnia, or the nature of which belongs to neuropathic pain. Benzodiazepines can be considered as an adjuvant to other analgesics in these circumstances. The role of benzodiazepines and related drugs in pain control for terminally ill patients remains limited. Further experiment and investigation are still warranted.

並列關鍵字

benzodiazepine ； sedative-hypnotic ； hospice palliative care ； pain