Opioid misuse in gastroenterology and non-opioid management of abdominal pain.
Opioid misuse in gastroenterology and non-opioid management of abdominal pain.
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DOI：
10.1038/nrgastro.2017.141
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Drossman D
中科院分区：
文献类型：
--
作者：
Szigethy E;Knisely M;Drossman D
阿片类药物是最早用于各种疾病疼痛的药物之一，但发病率和死亡率与慢性使用越来越相关。尽管有这些负面影响，慢性阿片类药物的使用在世界范围内仍在增加，其中美国和加拿大的使用率最高。长期使用阿片类药物治疗非癌性疼痛会对胃肠道和中枢神经系统产生特别负面的影响，包括阿片类药物引起的便秘、麻醉性肠综合征、精神病理恶化和成瘾。本综述总结了胃肠病学中阿片类药物滥用的证据，包括缺乏这些药物有益的证据，以及阿片类药物使用相对于脑肠轴的危害风险和负面后果。指南阿片类药物管理和替代药物和非药物策略的疼痛管理患者胃肠道疾病也进行了讨论。由于慢性疼痛是复杂的，涉及情绪和社会因素，针对疼痛强度和生活质量的多模式方法是最好的。
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction. This Review summarizes the evidence of opioid misuse in gastroenterology, including the lack of evidence of a benefit from these drugs, as well as the risk of harm and negative consequences of opioid use relative to the brain–gut axis. Guidelines for opioid management and alternative pharmacological and nonpharmacological strategies for pain management in patients with gastrointestinal disorders are also discussed. As chronic pain is complex and involves emotional and social factors, a multimodal approach targeting both pain intensity and quality of life is best.
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DOI：
10.1097/ajp.0b013e3181f195ba
发表时间：
2010-11
期刊：
The Clinical journal of pain
影响因子：
--
作者：
Butler SF;Budman SH;Fanciullo GJ;Jamison RN
通讯作者：
Jamison RN
影响因子：
2
作者：
Altayar O;Sharma V;Prokop LJ;Sood A;Murad MH
通讯作者：
Murad MH
影响因子：
5.9
作者：
Bawa, Fathima L. Marikar;Mercer, Stewart W.;Bond, Christine M.
通讯作者：
Bond, Christine M.
影响因子：
6
作者：
Boscarino, Joseph A.;Rukstalis, Margaret;Stewart, Walter F.
通讯作者：
Stewart, Walter F.
影响因子：
1.7
作者：
Brennan, Brian P.;Fogarty, Kate V.;Hudson, James I.
通讯作者：
Hudson, James I.