21/06/01 13:23:41.44 metd5+s90.net
>>202
モルヒネ以上の鎮痛効果なんてないから。
あるなら、海外で痛み止めの1番になってないとおかしい。
ガイドラインにも鎮痛効果なんてほとんど取り上げられてない。
ESMOのガイドラインね。
Treatment for cancer pain varies between individual patients, but in general:
- Mild cancer pain may be treated with non-opioid analgesics such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs; e.g. aspirin, ibuprofen, diclofenac). These may be used alone or in combination with opioids.
- Mild to moderate cancer pain may be treated with weak opioids such as codeine, dihydrocodeine or tramadol. These might be given alongside non-opioids.
- Moderate to severe cancer pain is usually treated with strong opioids, including morphine, oxycodone, fentanyl, hydromorphone and methadone. Morphine is the most commonly used opioid for moderate to severe cancer pain.
• Episodes of breakthrough cancer pain are typically treated with fast-acting opioids, usually morphine or fentanyl.
• Cancer-related bone pain caused by bone metastases can be treated with radiotherapy, bisphosphonates and denosumab as well as analgesic drugs. Bisphosphonates and denosumab
are not considered pain medications as such, but can delay the onset of bone pain and prevent bone complications such as fractures. Percutaneous vertebroplasty can also reduce spinal pain by stabilising the bones.
• Pain from spinal cord compression caused by metastases is typically treated with radiotherapy with or without steroids, and occasionally with surgery to remove the tumour or stabilise the vertebrae.
• Neuropathic pain can be caused by the cancer itself, cancer therapies or infections (such as herpes zoster). It causes unpleasant sensations and can be difficult to treat. Neuropathic pain in patients with cancer is treated with opioids as well as adjuvant drugs that can reduce nerve pain, including anticonvulsants, antidepressants and lidocaine patches.
• Refractory pain (persistent pain that is not relieved by standard drug treatments) may rarely require more invasive strategies, such as intrathecal opioid treatment, peripheral nerve block