Direct conversion from oral morphine to transdermal fentanyl: A multicenter study in patients with cancer pain
Direct conversion from oral morphine to transdermal fentanyl: A multicenter study in patients with cancer pain
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DOI：
10.1016/0304-3959(95)00180-8
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发表时间：
1996-03-01
期刊：
影响因子：
7.4
通讯作者：
Strumpf, M
中科院分区：
文献类型：
--
作者：
Donner, B;Zenz, M;Strumpf, M
在癌痛患者中检查了从口服吗啡到透皮芬太尼的直接转换，每日口服吗啡/透皮芬太尼（100：1 mg）的比例。在为期6天的研究前阶段，接受恒定剂量缓释吗啡的“稳定和低水平癌痛”患者被纳入研究。初始芬太尼剂量由换算表计算。每72小时更换一次透皮系统，根据VAS评分和液体吗啡的要求根据患者的需要调整剂量，以达到充分的疼痛缓解。研究结束时的回归分析显示，平均吗啡/透皮芬太尼比例为70：1。芬太尼透皮贴剂治疗期间的疼痛缓解与缓释吗啡相同。然而，更多的患者在芬太尼透皮治疗期间服用液体吗啡补充药物。使用芬太尼透皮贴剂后，疼痛发作的患者数量并未增加。芬太尼治疗期间，便秘和使用泻药的情况显著减少。其他副作用和生命体征相同。三名患者在芬太尼透皮治疗的前24小时内出现吗啡戒断综合征。贴剂的皮肤反应罕见、轻度和一过性。患者和医生对透皮治疗表示满意。94.7%的患者在研究结束时选择继续芬太尼透皮贴剂治疗，因为与口服吗啡相比，芬太尼透皮贴剂治疗的效果更好。由于这些结果，以100：1的比例从口服吗啡到芬太尼透皮贴剂的初始转换是安全有效的。
Direct conversion from oral morphine to transdermal fentanyl with a ratio of oral morphine/transdermal fentanyl (100:1 mg) daily was examined in patients with cancer pain. Patients with a 'stable and low level of cancer pain' receiving a constant dosage of sustained release morphine during a pre-study phase of 6 days were included in the study. Initial fentanyl dosage was calculated by a conversion table. The transdermal system was changed every 72 h and the dosage was adjusted to the needs of the patients according to the VAS scores and the requirement of liquid morphine, which was allowed to achieve sufficient pain relief.Regression analysis at the end of the study revealed a mean morphine/transdermal fentanyl ratio of 70:1. Pain relief during treatment with transdermal fentanyl was identical to sustained release morphine. However, significantly more patients took supplemental medication with liquid morphine during transdermal fentanyl therapy. The number of patients suffering from pain attacks did not increase with transdermal fentanyl. Constipation and medication with laxatives decreased significantly during fentanyl therapy. Other side effects and vital signs were identical. Three patients suffered from a morphine withdrawal syndrom beginning within the first 24 h of transdermal fentanyl therapy. Cutaneous reactions to the patch were rare, mild and transient. Patients and physicians reported satisfaction with the transdermal therapy. 94.7% of the patients chose to continue the transdermal fentanyl therapy at the end of the study due to better performance in comparison to oral morphine.Due to these results an initial conversion from oral morphine to transdermal fentanyl with the ratio of 100:1 is safe and effective.