Fentanyl注射劑在加護病房的使用角色

國內對於加護病患的疼痛問題，大多採取較消極的處理方式，主要是因為藥物的安全性不夠高，常使醫師望之卻步，例如NSAIDs的腸胃道及腎臟毒性；meperidine的中樞神經毒性（抽搐）；morphine的血流動力學不穩定及成癮性等問題。但重症病患經常必須使用各種不同的侵入性檢查與治療，如果無法提供足夠的疼痛控制，可能增加病人因疼痛而引發的各種不良反應（像急性心肌梗塞、免疫功能下降、血糖不易控制等），延長住院時間甚至導致死亡。因此先進國家的加護中心，會積極的使用fentanyl針劑作為第一線的止痛劑，因為不論是從有效性、安全性或方便性的觀點來看，fentanyl均比morphine更能改善病患疼痛、提昇醫療品質，值得作為國內加護病患照顧的學習參考與推廣。

關鍵字

吩坦尼；止痛；持續性滴注；呼吸抑制；視覺對比量表

並列摘要

Pain-control service is always inadequate in intensive care units (ICU) of Taiwan. Adverse drug reactions are the main reason to under-prescribe analgesics, as nonsteroidal anti-inflammatory drugs lead to gastrointestinal bleeding and nephrotoxicity; meperidine-related seizures; morphine has unstable hemodynamics and addictives problems. However, lots of invasive procedures are necessary for critical illness patients. The possibility to induce the complication (e. g. acute myocardial infarction, immunosuppression, insulin resistance) maybe increase, and the outcome will prolong the hospital stay even death if we could not provide adequate pain-control. In the developed country, fentanyl injection is the first-line analgesic in ICU. Fentanyl has lots of advantages more than morphine in safety, efficacy and convenience to improve healthcare quality. It is worthy to learn and apply in ICU of Taiwan.

並列關鍵字

Fentanyl ； Analgesia ； Continuous IV infusion ； Respiratory depression ； Visual analog scale ； VAS

國際替代計量

Fentanyl注射劑在加護病房的使用角色

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