Methadone for Pain Management in Chemotherapy-Induced Peripheral Neuropathy: A Retrospective Review.

IF 0.9 Q3 ANESTHESIOLOGY
Christiane Boen, Julia Ridley, Philippa Hawley
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Abstract

Chemotherapy-Induced Peripheral Neuropathy (CIPN) refers to damage of peripheral nerve fibers due to the use of neurotoxic chemotherapy to treat various cancers. It occurs in more than 30% of patients and only duloxetine has currently been identified to show limited efficacy in symptomatic treatment of CIPN. Opioids have traditionally been used to treat cancer pain, and there is evidence for their use in treatment of peripheral neuropathic pain from other causes. With a similar mechanism of action to duloxetine, methadone has rationale for treating neuropathic pain. This study is a retrospective chart review to evaluate the outcomes of using methadone for CIPN pain. Out of 31 patients, 65% felt that methadone was an effective treatment, 19% felt that it was ineffective, and 16% felt that it was partially or temporarily effective. These results suggest that analgesic response to methadone varies between patients, but that it has a potential role in painful CIPN. Its advantages for long-term use include low cost and lack of metabolites. Potential risks include a long half-life, drug interactions, and potential for QT prolongation at high doses. Prospective studies should be conducted to evaluate the role of methadone in CIPN pain management more comprehensively.

美沙酮用于化疗引起的周围神经病变的疼痛治疗:回顾性综述。
化疗诱发的周围神经病(CIPN)是指由于使用神经毒性化疗来治疗各种癌症而导致的周围神经纤维损伤。30%以上的患者会出现这种情况,目前只有度洛西汀在对症治疗 CIPN 方面显示出有限的疗效。阿片类药物历来被用于治疗癌痛,也有证据表明它们可用于治疗其他原因引起的周围神经痛。美沙酮的作用机制与度洛西汀相似,因此具有治疗神经病理性疼痛的合理性。本研究是一项回顾性病历审查,旨在评估使用美沙酮治疗 CIPN 疼痛的效果。在 31 名患者中,65% 认为美沙酮是一种有效的治疗方法,19% 认为无效,16% 认为部分有效或暂时有效。这些结果表明,不同患者对美沙酮的镇痛反应各不相同,但美沙酮对 CIPN 疼痛有潜在作用。长期使用美沙酮的优点包括成本低和不产生代谢物。潜在风险包括半衰期长、药物相互作用以及大剂量时可能导致 QT 延长。应开展前瞻性研究,更全面地评估美沙酮在 CIPN 疼痛治疗中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
9.10%
发文量
40
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