使用局部吗啡缓解压力性溃疡疼痛。

CONSULTANT PHARMACIST Pub Date : 2018-04-01 DOI:10.4140/TCP.n.2018.215

Sandra L Discala, Danny Basri, Christine M Vartan, Michael A Silverman

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引用次数: 6

摘要

简介:局部吗啡是一个潜在的治疗选择，在临终关怀和姑息治疗患者的疼痛性压疮倾向于避免全身阿片类药物治疗。病例:一名65岁的非裔美国男性退伍军人患有疼痛的3期骶骨压迫性损伤，他不愿服用全身阿片类药物来控制疼痛，因为他希望为家人和朋友保持警惕。局部吗啡开始，并在24小时内，病人报告疼痛在数字评定量表显著减少。讨论:姑息性药物治疗的重点是减轻疾病的症状，同时避免影响生活质量的副作用。有证据表明，局部吗啡是治疗疼痛性压疮的有效选择，可以减少某些患者对全身阿片类药物的需求。结论:在姑息治疗环境中，当全身镇痛药治疗不希望、不充分或耐受性差时，可以考虑局部吗啡用于同情性使用。

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Use of Topical Morphine to Relieve Painful Pressure Ulcers.

Introduction: Topical morphine is a potential treatment option for painful pressure ulcers in hospice and palliative care patients who favor avoidance of systemic opioid therapy.

Case: A 65-year-old male African-American veteran with a painful stage 3 sacral pressure injury was hesitant to take systemic opioids to control his pain, as he wished to stay alert for family and friends. Topical morphine was initiated, and within 24 hours the patient reported a significant reduction in pain on the numeric rating scale.

Discussion: Palliative pharmacotherapy is focused on reducing the symptoms of disease while avoiding side effects that impair quality of life. Evidence suggests topical morphine can be an effective treatment option for painful pressure ulcers and can reduce the need for systemic opioids in select patients.

Conclusion: In the palliative care setting, topical morphine may be considered for compassionate use when treatment with systemic analgesics is undesired, inadequate, or poorly tolerated.

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来源期刊

CONSULTANT PHARMACIST PHARMACOLOGY & PHARMACY-

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期刊介绍： Vision ... The Society"s long-term desire, aspiration, and core purpose. The vision of the American Society of Consultant Pharmacists is optimal medication management and improved health outcomes for all older persons. Mission ... The Society"s strategic position, focus, and reason for being. The American Society of Consultant Pharmacists empowers pharmacists to enhance quality of care for all older persons through the appropriate use of medication and the promotion of healthy aging.