緩和醫學中非癌症慢性疼痛的鴉片類藥物治療

Opioid Therapy in Palliative Care for Chronic Noncancer Pain

許煌汶(Huang-Wen Hsu)

《安寧療護雜誌》 10卷4期 (2005/11) Pp. 384-394

https://doi.org/10.6537/TJHPC.2005.10(4).6

摘要

非癌症慢性疼痛是臨床實務常見的疾病，其原因有很多種。由於病人常伴隨有身體、心理與社會等層面的異常與痛苦，常使得非癌症慢性疼痛病人的處理變得複雜。因此，緩和醫學中的整體性照顧，應該是處理這種病人的重要方式。鴉片類藥物是治療中度至重度癌痛的首選藥物，但是要長期使用在非癌症疼痛病人的治療，則仍有一些爭議，主要考量在於鴉片類藥物的療效實証與副作用，以及成癮的風險。本文從非癌症慢性疼痛的基本認知、鴉片類藥物的治療實証與使用指引，以及政府法規管制等方面作一討論，以作為醫護人員在臨床實務上的參考。

關鍵字

非癌症慢性疼痛整 ； 體性照顧 ； 鴉片類藥物

並列摘要

Chronic noncancer pain (CNCP) is common in clinical practice and has many etiologies. The patients with CNCP are usually associated with physical, emotional and social disability, and often complicates its management. The mode of total care in palliative medicine should be an important modality in managing patients with CNCP. Opioids are the drug of choice for the moderate to severe cancer pain relief. There are still some debates in the long-term opioid therapy of patients with CNCP, mainly because of the consideration of its efficacy, adverse effects, and the risk of addiction.. In this article, we will discuss the basic knowledge of CNCP, the evidence-based efficacy of opioid therapy, and legal regulation from the government.

並列關鍵字

chronic noncancer pain ； total care ； opioid