Switching from morphine to oral methadone in treating cancer pain: What is the equianalgesic dose ratio?
Switching from morphine to oral methadone in treating cancer pain: What is the equianalgesic dose ratio?
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DOI：
10.1200/jco.1998.16.10.3216
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发表时间：
1998-10-01
影响因子：
45.3
通讯作者：
De Conno, F
中科院分区：
文献类型：
--
作者：
Ripamonti, C;Groff, L;De Conno, F
目的：确定一组从吗啡改为口服美沙酮的晚期癌症疼痛患者中吗啡和美沙酮的剂量比，与之前的吗啡剂量和达到相同镇痛水平所需的天数有关。患者和方法：对连续 38 名从吗啡改为口服美沙酮的癌症患者进行了一项横断面前瞻性研究。通过四点口头李克特量表评估转换期之前、期间和之后的疼痛强度。分别采用皮尔逊相关系数、散点图和Cuzick趋势检验分析既往吗啡剂量与最终等镇痛美沙酮剂量之间的关系、吗啡与美沙酮的剂量比以及达到等镇痛所需天数。结果：转换前吗啡的中位口服当量每日剂量为145 mg/d；转换后，中位等镇痛口服美沙酮剂量为 21 mg/d。口服美沙酮达到镇痛效果所需的中位时间为 3 天（范围为 1 至 7 天）；转换前的吗啡剂量越低，口服美沙酮达到镇痛效果所需的天数就越少（P
Purpose: To define the dose ratio between morphine and methadone in relation to the previous morphine dose and the number of days needed to achieve the same level of analgesia in a group of patients with advanced cancer with pain who switched from morphine to oral methadone.Patients and Methods: A cross-sectional prospective study of 38 consecutive cancer patients who switched from morphine to oral methadone was performed. The intensity of pain before, during, and after the switching period was assessed through a four-point verbal Likert scale. The relationship between previous morphine dose and the final equianalgesic methadone dose, dose ratio between morphine and methadone, and the number of days required to achieve equianalgesia have been examined by means of pearson's correlation coefficient, scatter plots, and Cuzick's test for trend respectively.Results: Before the switch, the median oral equivalent daily dose of morphine was 145 mg/d; after the switch, the median equianalgesic oral methadone dose wets 21 mg/d. A median time of 3 days (range, 1 to 7 days) was necessary to achieve the equianalgesia with oral methadone; the lower the preswitching morphine dose, the fewer days necessary to achieve equianalgesia with oral methadone (P