The adverse effects of morphine: a prospective survey of common symptoms during repeated dosing for chronic cancer pain.
The adverse effects of morphine: a prospective survey of common symptoms during repeated dosing for chronic cancer pain.
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DOI：
10.1177/1049909106289068
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发表时间：
2006-06-01
期刊：
影响因子：
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通讯作者：
Sheehan, Denice
中科院分区：
文献类型：
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作者：
Glare, Paul;Walsh, Declan;Sheehan, Denice
关于慢性癌痛重复个体化给药过程中吗啡副作用的发生率、患病率或严重程度的信息很少，尽管它已被广泛使用超过30年。作者的目的是描述在晚期癌症疼痛患者的方便样本中可能归因于吗啡副作用的症状的患病率。他们对定期服用吗啡的住院患者和门诊患者进行了前瞻性调查，每周进行一次问卷调查，持续4周。56例合格患者中有42例至少完成了第一份问卷，30例完成了所有4份问卷。口干是报告的最常见症状（点患病率，95%）;其强度通常为中度至重度（57%），并且是最持久的症状（阶段患病率，20%）。镇静和便秘是常见的（点患病率，88%），往往是中度或重度在某个点（分别为55%和62%），但有较低的时期患病率。不到一半的患者报告恶心。肌阵挛是常见的（点患病率，83%），但通常是轻度的，不持久。每日吗啡总剂量对副作用模式影响不大。剂量增加后，昏迷、烦躁不安、肌阵挛、恶心和镇静更可能为重度。总之，尽管便秘、恶心和镇静被充分描述为吗啡给药的副作用，但其他副作用如口干和肌阵挛似乎被低估了。需要基于患者的阿片类药物副作用的有效措施。
Little information is available about the incidence, prevalence, or severity of morphine side effects during repeated individualized dosing for chronic cancer pain, although it has been widely used in this way for more than 30 years. The authors' aim was to describe the prevalence of symptoms possibly attributable to morphine side effects in a convenience sample of patients with pain due to advanced cancer. They used a prospective survey of inpatients and outpatients on regularly dosed morphine, with a questionnaire administered weekly for 4 weeks. Forty-two of 56 eligible patients completed at least the first questionnaire, with 30 completing all 4. Dry mouth was the most common symptom reported (point prevalence, 95%); this was often moderate to severe in intensity (57%) and was the most persistent symptom (period prevalence, 20%). Sedation and constipation were frequent (point prevalence, 88%) and was often moderate or severe at some point (55% and 62%, respectively) but had low period prevalence. Nausea was reported by less than half the patients. Myoclonus was common (point prevalence, 83%) but was usually mild and not persistent. Total daily morphine dose had little impact on side-effect patterns. Constipation, dysphoria, myoclonus, nausea, and sedation were more likely to be severe following dose increases. In conclusion, although constipation, nausea, and sedation are well described as side effects of morphine administration, others such as dry mouth and myoclonus appear to be underestimated. Validated patient-based measures of opioid side effects are needed.