Frequency of Myoclonus and its Countermeasures in Terminally Ill Patients with Cancer: A Single-Center Retrospective Study.

IF 0.9 Q3 ANESTHESIOLOGY
Yoshihiro Yamamoto, Hiroaki Watanabe, Norio Watanabe, Yasuyuki Asai, Motozumi Ando, Masami Kawahara, Yuko Deguchi, Takuya Odagiri
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Abstract

Myoclonus is a relatively rare involuntary movement that is often observed in palliative care settings and that can cause patient distress. The purpose of this study is to investigate the occurrence of myoclonus and countermeasures against it in terminally ill patients with cancer diagnosed by palliative care specialists at Komaki City Hospital, Japan. We retrospectively reviewed patients with terminal cancer who received palliative care consultations between January 2018 and May 2019 and who were diagnosed with myoclonus by palliative care specialists, using electronic medical records. Patient demographics, time from onset of myoclonus to death, daily opioid use, countermeasures, and outcome of myoclonus were assessed. Of 360 patients examined during this period, 45 (12.5%) were diagnosed with myoclonus. Median age was 71 (range, 43-88) years; median time from onset of myoclonus to death was 8 days (range, 0-56); opioid usage was present in 39 patients (morphine, oxycodone, and fentanyl: n = 6, 21, and 12, respectively); and median oral morphine equivalent at onset of myoclonus was 60 mg (range, 12-336 mg). Myoclonus treatment was administered to 21 patients (opioid dose reduction, opioid switching, and others: n = 14, 3, and 4, respectively). Myoclonus is a common complication in patients with terminal cancer.

癌症晚期患者肌阵挛的发生频率及其对策:单中心回顾性研究
肌阵挛是一种相对罕见的不自主运动,在姑息治疗环境中经常可以观察到,并会给患者带来痛苦。本研究旨在调查由日本小牧市医院姑息治疗专家诊断的癌症晚期患者肌阵挛的发生情况和应对措施。我们利用电子病历对2018年1月至2019年5月期间接受姑息治疗会诊并被姑息治疗专家诊断为肌阵挛的晚期癌症患者进行了回顾性研究。评估了患者的人口统计学特征、肌阵挛发病至死亡的时间、每日阿片类药物的使用情况、对策以及肌阵挛的预后。在此期间接受检查的 360 名患者中,有 45 人(12.5%)被确诊为肌阵挛。中位年龄为 71 岁(43-88 岁);从肌阵挛发病到死亡的中位时间为 8 天(0-56 天);39 名患者使用了阿片类药物(吗啡、羟考酮和芬太尼:分别为 6、21 和 12);肌阵挛发病时的中位口服吗啡当量为 60 毫克(12-336 毫克)。21 名患者接受了肌阵挛治疗(减少阿片类药物剂量、更换阿片类药物及其他:人数分别为 14、3 和 4)。肌阵挛是癌症晚期患者常见的并发症。
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来源期刊
CiteScore
1.60
自引率
9.10%
发文量
40
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